{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:05:12Z","timestamp":1786125912463,"version":"build-2736575974"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004561","name":"Ministry of Education and Science of the Republic of Kazakhstan","doi-asserted-by":"publisher","award":["AP26100905"],"award-info":[{"award-number":["AP26100905"]}],"id":[{"id":"10.13039\/501100004561","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic carotid artery occlusive disease is associated with a high risk of ischemic events and long-term neurological deficits. Optimising surgical revascularisation outcomes requires an integrated understanding of anatomical, hemodynamic, and functional factors. This study aims to assess the neuro-radiological, clinical, and cognitive outcomes following cerebral revascularisation in patients with chronic internal carotid artery occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre, prospective, open-label interventional longitudinal study includes 60 patients with chronic internal carotid artery occlusion undergoing superficial temporal artery-to-middle cerebral artery (STA\u2013MCA) bypass at National Centre for Neurosurgery in Kazakhstan. The primary endpoint of the study is the incidence of ischemic stroke during the 6-month follow-up period after surgery. Pre- and postoperative evaluations include detailed angiographic assessment of collateral circulation and donor vessel diameter, as well as cerebral perfusion imaging using arterial spin labelling MRI. Neurological and cognitive function are assessed using standardized clinical and neuropsychological tests. Early and six-month follow-up evaluations focus on bypass patency, perfusion changes, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>By integrating anatomical, hemodynamic, and functional data, this study aims to identify predictors of successful revascularisation and favorable clinical outcomes. Correlation of postoperative angiographic and perfusion findings with cognitive and neurological recovery may refine surgical decision-making, enhance risk stratification, and optimize individualized patient care. Ultimately, this comprehensive approach seeks to improve the overall efficacy and safety of STA-MCA bypass in patients with chronic carotid artery occlusive disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT07396025\" xlink:type=\"simple\">NCT07396025<\/jats:ext-link>\n                      . Registered on February 5, 2026.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0354103","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:24:42Z","timestamp":1786123482000},"page":"e0354103","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemodynamic, neurological, and cognitive outcomes after surgical revascularisation in occlusive cerebrovascular disease: Study protocol for single-arm interventional cohort study"],"prefix":"10.1371","volume":"21","author":[{"given":"Chingiz","family":"Nurimanov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-6350","authenticated-orcid":true,"given":"Karashash","family":"Menlibayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0427-1751","authenticated-orcid":true,"given":"Iroda","family":"Mammadinova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6205-9292","authenticated-orcid":true,"given":"Ainur","family":"Turzhanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6301-4050","authenticated-orcid":true,"given":"Seitzhan","family":"Aidarov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daultay","family":"Batyrkhanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assel","family":"Kabykenova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yerbol","family":"Makhambetov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assylbek","family":"Kaliyev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"issue":"10","key":"pone.0354103.ref001","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1474-4422(24)00369-7","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021","volume":"23","author":"GBD 2021 Stroke Risk Factor Collaborators","year":"2024","journal-title":"Lancet Neurol"},{"issue":"2","key":"pone.0354103.ref002","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1177\/17474930241308142","article-title":"World Stroke Organization: Global Stroke Fact Sheet 2025","volume":"20","author":"VL Feigin","year":"2025","journal-title":"International Journal of Stroke: Official Journal of the International Stroke Society"},{"key":"pone.0354103.ref003","doi-asserted-by":"crossref","DOI":"10.1093\/neuros\/nyz042","article-title":"Epidemiology, natural history, and clinical presentation of large vessel ischemic stroke","volume":"85","author":"RC Rennert","year":"2019","journal-title":"Neurosurgery"},{"issue":"19","key":"pone.0354103.ref004","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1056\/NEJM198511073131904","article-title":"Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial","volume":"313","author":"EC\/IC Bypass Study Group","year":"1985","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0354103.ref005","doi-asserted-by":"crossref","DOI":"10.3171\/2013.10.FOCUS13427","article-title":"Extracranial-intracranial bypass for ischemic cerebrovascular disease: What have we learned from the Carotid Occlusion Surgery Study?","volume":"36","author":"MR Reynolds","year":"2014","journal-title":"Neurosurg Focus"},{"key":"pone.0354103.ref006","first-page":"524","article-title":"JET study (Japanese EC-IC Bypass Trial)","author":"K Ogasawara","year":"2006","journal-title":"Nihon Rinsho"},{"issue":"6","key":"pone.0354103.ref007","doi-asserted-by":"crossref","first-page":"460","DOI":"10.2176\/nmc.oa.2014-0424","article-title":"Results of Prospective Cohort Study on Symptomatic Cerebrovascular Occlusive Disease Showing Mild Hemodynamic Compromise [Japanese Extracranial-Intracranial Bypass Trial (JET)-2 Study]","volume":"55","author":"H Kataoka","year":"2015","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"pone.0354103.ref008","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.clineuro.2018.04.003","article-title":"Long-term outcome in extracranial-intracranial bypass surgery for severe steno-occlusive disease of intracranial internal carotid or middle cerebral artery","volume":"169","author":"KAC Teo","year":"2018","journal-title":"Clin Neurol Neurosurg"},{"issue":"4","key":"pone.0354103.ref009","first-page":"745","article-title":"Evidence of efficacy of superficial temporal artery-middle cerebral artery bypass in Japan","volume":"50","author":"T Hishikawa","year":"2022","journal-title":"No shinkei geka Neurological surgery"},{"issue":"6","key":"pone.0354103.ref010","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1227\/ons.0000000000000177","article-title":"Modern Appraisal of patency and complications in cerebral bypass surgery: A single institution experience","volume":"22","author":"J Farooq","year":"2022","journal-title":"Oper Neurosurg"},{"issue":"1","key":"pone.0354103.ref011","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1159\/000512106","article-title":"Efficacy and safety of timely urgent superficial temporal artery-to-middle cerebral artery bypass surgery in patients with acute ischemic stroke: A single-institutional prospective study and a pooled analysis","volume":"50","author":"JH Kim","year":"2021","journal-title":"Cerebrovasc Dis"},{"issue":"1","key":"pone.0354103.ref012","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/NRL.0000000000000086","article-title":"Urgent bypass surgery following failed endovascular treatment in acute symptomatic stroke patient with MCA occlusion","volume":"22","author":"CY Lee","year":"2017","journal-title":"Neurologist"},{"issue":"1","key":"pone.0354103.ref013","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1515\/tnsci-2022-0211","article-title":"Ischemic stroke following STA-MCA double bypass","volume":"13","author":"H Zhao","year":"2022","journal-title":"Translational Neuroscience"},{"issue":"1","key":"pone.0354103.ref014","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4103\/ajns.AJNS_485_20","article-title":"Impact of extracranial-intracranial bypass on cognitive function in a patient with chronic cerebral ischemia","volume":"16","author":"T Aono","year":"2021","journal-title":"Asian J Neurosurg"},{"issue":"5","key":"pone.0354103.ref015","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"JC van Swieten","year":"1988","journal-title":"Stroke"},{"key":"pone.0354103.ref016","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.wneu.2023.12.044","article-title":"Great Hospitals of Central Asia: The Kazakhstan National Centre for Neurosurgery","volume":"183","author":"S Akshulakov","year":"2024","journal-title":"World Neurosurg"},{"issue":"3","key":"pone.0354103.ref017","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/geronj\/37.3.323","article-title":"Measurement of functional activities in older adults in the community","volume":"37","author":"RI Pfeffer","year":"1982","journal-title":"J Gerontol"},{"issue":"4","key":"pone.0354103.ref018","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"ZS Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"issue":"7","key":"pone.0354103.ref019","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1080\/13854046.2024.2446028","article-title":"The Rey Auditory Verbal Learning Test: Adaptation into Russian and a new digital \u201cRAVLT World\u201d","volume":"39","author":"S Malyutina","year":"2025","journal-title":"Clin Neuropsychol"},{"issue":"5","key":"pone.0354103.ref020","first-page":"357","article-title":"The block-design tests","volume":"3","author":"SC Kohs","year":"1920","journal-title":"J JoEP"},{"key":"pone.0354103.ref021","first-page":"557","article-title":"The stroop color and word test","volume":"8","author":"F Scarpina","journal-title":"Frontiers in psychology"},{"issue":"1","key":"pone.0354103.ref022","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s00701-024-06305-6","article-title":"A novel intraoperative \u201cFaucet\u201d technique for assessing patency of superficial temporal artery to middle cerebral artery bypass and for prevention of microemboli","volume":"166","author":"C Nurimanov","year":"2024","journal-title":"Acta Neurochir (Wien)"},{"issue":"6","key":"pone.0354103.ref023","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1161\/STROKEAHA.110.579888","article-title":"Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: A population-based study","volume":"41","author":"ST Pendlebury","year":"2010","journal-title":"Stroke"},{"issue":"10","key":"pone.0354103.ref024","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.3174\/ajnr.A7622","article-title":"Testing an Adapted Auditory Verbal Learning Test Paradigm for fMRI to Lateralize Verbal Memory in Patients with Epilepsy","volume":"43","author":"E Conde-Blanco","year":"2022","journal-title":"AJNR Am J Neuroradiol"},{"issue":"11","key":"pone.0354103.ref025","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1002\/gps.1010","article-title":"Rey verbal learning test is a useful tool for differential diagnosis in the preclinical phase of Alzheimer\u2019s disease: Comparison with mild cognitive impairment and normal aging","volume":"18","author":"A Est\u00e9vez-Gonz\u00e1lez","year":"2003","journal-title":"Int J Geriatr Psychiatry"},{"issue":"8","key":"pone.0354103.ref026","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/0145482X0209600805","article-title":"Testing nonverbal intelligence of working-age visually impaired adults: Evaluation of the adapted kohs block design test","volume":"96","author":"JMV Reid","year":"2002","journal-title":"Journal of Visual Impairment & Blindness"},{"issue":"11","key":"pone.0354103.ref027","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1016\/j.apmr.2006.07.267","article-title":"Predicting recovery of upper-body dressing ability after stroke","volume":"87","author":"M Suzuki","year":"2006","journal-title":"Arch Phys Med Rehabil"},{"issue":"2","key":"pone.0354103.ref028","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3233\/NRE-220171","article-title":"Cortical hemodynamic response during cognitive Stroop test in acute stroke patients assessed by fNIRS","volume":"52","author":"AV Heiberg","year":"2023","journal-title":"NeuroRehabilitation"},{"key":"pone.0354103.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/23279095.2026.2655912","article-title":"Test-retest reliability and responsiveness of the Stroop Color and Word test in patients with stroke","author":"E-C Chiu","year":"2026","journal-title":"Appl Neuropsychol Adult"},{"issue":"1","key":"pone.0354103.ref030","doi-asserted-by":"crossref","first-page":"18352","DOI":"10.1038\/s41598-023-45676-1","article-title":"The value of indocyanine green-FLOW800 in microvasculature for predicting cerebral hyperperfusion syndrome in moyamoya disease patients","volume":"13","author":"Z Guo","year":"2023","journal-title":"Sci Rep"},{"issue":"4","key":"pone.0354103.ref031","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1590\/S1516-44462006005000053","article-title":"The rey auditory-verbal learning test: Applicability for the Brazilian elderly population","volume":"29","author":"LF Malloy-Diniz","year":"2007","journal-title":"Revista Brasileira de Psiquiatria"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:24:48Z","timestamp":1786123488000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354103"}},"subtitle":[],"editor":[{"given":"Haipeng","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":31,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0354103","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}