{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:14:43Z","timestamp":1769728483910,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"\n BACKGROUND<\/jats:title>\n De novo aneurysm formation at the anastomotic site of superficial temporal artery (STA)\u2013middle cerebral artery (MCA) bypass surgery for moyamoya disease (MMD) is an exceptionally rare but clinically significant complication. Previously reported cases were treated with direct microsurgery, where preservation of established pial synangiosis was a major concern. The authors herein report the first case successfully treated with endovascular coil embolization, achieving complete preservation of pial synangiosis and a favorable clinical outcome.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 53-year-old man had undergone combined revascularization surgery for MMD 14 years earlier. Although the patient remained asymptomatic, follow-up MR angiography revealed a gradually enlarging de novo aneurysm with daughter sac formation at the anastomotic site. Cerebral angiography demonstrated a narrow-neck saccular aneurysm and a well-developed donor STA, allowing access for endovascular treatment. A microcatheter was advanced into the aneurysm via a distal access catheter placed in the STA, and coil embolization with five coils achieved complete obliteration. The patient recovered uneventfully, and follow-up imaging confirmed the durable occlusion.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Endovascular therapy represents a valuable treatment option for de novo aneurysm after STA-MCA anastomosis in MMD, as it completely preserves established collaterals. Careful patient selection and meticulous procedural planning are essential to ensure safety and efficacy.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25666<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25666","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:06:51Z","timestamp":1762214811000},"source":"Crossref","is-referenced-by-count":0,"title":["Coil embolization via donor superficial temporal artery for de novo aneurysm associated with revascularization surgery in a patient with moyamoya disease: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Toma","family":"Shirai","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7488-4820","authenticated-orcid":true,"given":"Kota","family":"Kurisu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5570-1726","authenticated-orcid":true,"given":"Toshiya","family":"Osanai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6567-8136","authenticated-orcid":true,"given":"Haruto","family":"Uchino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0991-0516","authenticated-orcid":true,"given":"Miki","family":"Fujimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"bib1","series-title":"Neurol Med Chir (Tokyo)","first-page":"307","article-title":"Diagnostic criteria for moyamoya disease\u20142021 revised version","volume":"62","author":"Kuroda","year":"2022","unstructured":"Kuroda SFujimura MTakahashi JDiagnostic criteria for moyamoya disease\u20142021 revised version. Neurol Med Chir (Tokyo). 2022;62(7):307-312."},{"issue":"3","key":"bib2","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","unstructured":"Suzuki JTakaku A.Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288-299."},{"issue":"4","key":"bib3","series-title":"Neurol Med Chir (Tokyo)","first-page":"165","article-title":"2021 Japanese guidelines for the management of moyamoya disease: guidelines from the research committee on moyamoya disease and Japan stroke society","volume":"62","author":"Fujimura","year":"2022","unstructured":"Fujimura MTominaga TKuroda S2021 Japanese guidelines for the management of moyamoya disease: guidelines from the research committee on moyamoya disease and Japan stroke society. Neurol Med Chir (Tokyo). 2022;62(4):165-170."},{"issue":"10","key":"bib4","series-title":"Stroke","first-page":"2610","article-title":"Predictors and clinical features of postoperative hyperperfusion after surgical revascularization for moyamoya disease: a serial single photon emission CT\/positron emission tomography study","volume":"43","author":"Uchino","year":"2012","unstructured":"Uchino HKuroda SHirata KShiga THoukin KTamaki N.Predictors and clinical features of postoperative hyperperfusion after surgical revascularization for moyamoya disease: a serial single photon emission CT\/positron emission tomography study. 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J Neurosurg. 2014;121(2):432-440."},{"issue":"3","key":"bib8","series-title":"Neurosurg Rev","first-page":"517","article-title":"Navigation-guided clipping of a de novo aneurysm associated with superficial temporal artery-middle cerebral artery bypass combined with indirect pial synangiosis in a patient with moyamoya disease","volume":"40","author":"Aburakawa","year":"2017","unstructured":"Aburakawa DFujimura MNiizuma KSakata HEndo HTominaga T.Navigation-guided clipping of a de novo aneurysm associated with superficial temporal artery-middle cerebral artery bypass combined with indirect pial synangiosis in a patient with moyamoya disease. 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Acta Neurochir (Wien). 2010;152(6):1069-1073."},{"issue":"3","key":"bib12","series-title":"Surg Neurol","first-page":"261","article-title":"A ruptured middle cerebral artery aneurysm originating from the site of anastomosis 20 years after extracranial-intracranial bypass for moyamoya disease: case report","volume":"64","author":"Nishimoto","year":"2005","unstructured":"Nishimoto TYuki KSasaki TMurakami TKodama YKurisu K.A ruptured middle cerebral artery aneurysm originating from the site of anastomosis 20 years after extracranial-intracranial bypass for moyamoya disease: case report. 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Stroke. 2024;55(6):1699-1706."},{"issue":"1","key":"bib15","series-title":"Neurol Med Chir (Tokyo)","first-page":"1","article-title":"Histological features of middle cerebral arteries from patients treated for moyamoya disease","volume":"47","author":"Takagi","year":"2007","unstructured":"Takagi YKikuta KNozaki KHashimoto N.Histological features of middle cerebral arteries from patients treated for moyamoya disease. Neurol Med Chir (Tokyo). 2007;47(1):1-4."},{"issue":"3","key":"bib16","series-title":"Virchows Arch A Pathol Anat Histol","first-page":"247","article-title":"Cerebral haemorrhage in moyamoya disease at autopsy","volume":"392","author":"Oka","year":"1981","unstructured":"Oka KYamashita MSadoshima STanaka K.Cerebral haemorrhage in moyamoya disease at autopsy. Virchows Arch A Pathol Anat Histol. 1981;392(3):247-261."},{"issue":"1","key":"bib17","series-title":"Tohoku J Exp Med","first-page":"45","article-title":"Current status of revascularization surgery for moyamoya disease: special consideration for its \u2018internal carotid-external carotid (IC-EC) conversion\u2019 as the physiological reorganization system","volume":"236","author":"Fujimura","year":"2015","unstructured":"Fujimura MTominaga T.Current status of revascularization surgery for moyamoya disease: special consideration for its \u2018internal carotid-external carotid (IC-EC) conversion\u2019 as the physiological reorganization system. Tohoku J Exp Med. 2015;236(1):45-53."},{"issue":"6","key":"bib18","series-title":"Neurol Med Chir (Tokyo)","first-page":"290","article-title":"Association between RNF213 p.R4810K and progression of cerebral artery negative remodeling in moyamoya disease","volume":"65","author":"Uchino","year":"2025","unstructured":"Uchino HIto MSugiyama TKurisu KFujima NFujimura M.Association between RNF213 p.R4810K and progression of cerebral artery negative remodeling in moyamoya disease. Neurol Med Chir (Tokyo). 2025;65(6):290-295."},{"issue":"3","key":"bib19","series-title":"Neurosurg Rev","first-page":"2305","article-title":"Impact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct\/indirect combined revascularization surgery for adult moyamoya disease","volume":"45","author":"Ito","year":"2022","unstructured":"Ito MKawabori MSugiyama TImpact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct\/indirect combined revascularization surgery for adult moyamoya disease. Neurosurg Rev. 2022;45(3):2305-2313."},{"issue":"11","key":"bib20","series-title":"Neurol Med Chir (Tokyo)","first-page":"1012","article-title":"Intracerebral hemorrhage from a ruptured aneurysm at the site of anastomosis 27 years after superficial temporal artery-middle cerebral artery bypass","volume":"50","author":"Hokari","year":"2010","unstructured":"Hokari MYasuda HIwasaki MIntracerebral hemorrhage from a ruptured aneurysm at the site of anastomosis 27 years after superficial temporal artery-middle cerebral artery bypass. Neurol Med Chir (Tokyo). 2010;50(11):1012-1014."},{"issue":"7","key":"bib1","series-title":"Neurol Med Chir (Tokyo)","first-page":"307","article-title":"Diagnostic criteria for moyamoya disease\u20142021 revised version","volume":"62","author":"Kuroda","year":"2022","unstructured":"Kuroda SFujimura MTakahashi JDiagnostic criteria for moyamoya disease\u20142021 revised version. Neurol Med Chir (Tokyo). 2022;62(7):307-312."},{"issue":"3","key":"bib2","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","unstructured":"Suzuki JTakaku A.Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288-299."},{"issue":"4","key":"bib3","series-title":"Neurol Med Chir (Tokyo)","first-page":"165","article-title":"2021 Japanese guidelines for the management of moyamoya disease: guidelines from the research committee on moyamoya disease and Japan stroke society","volume":"62","author":"Fujimura","year":"2022","unstructured":"Fujimura MTominaga TKuroda S2021 Japanese guidelines for the management of moyamoya disease: guidelines from the research committee on moyamoya disease and Japan stroke society. Neurol Med Chir (Tokyo). 2022;62(4):165-170."},{"issue":"10","key":"bib4","series-title":"Stroke","first-page":"2610","article-title":"Predictors and clinical features of postoperative hyperperfusion after surgical revascularization for moyamoya disease: a serial single photon emission CT\/positron emission tomography study","volume":"43","author":"Uchino","year":"2012","unstructured":"Uchino HKuroda SHirata KShiga THoukin KTamaki N.Predictors and clinical features of postoperative hyperperfusion after surgical revascularization for moyamoya disease: a serial single photon emission CT\/positron emission tomography study. Stroke. 2012;43(10):2610-2616."},{"key":"bib5","series-title":"Acta Neurochir Suppl","first-page":"99","article-title":"Efficacy and safety of combined revascularization surgery for moyamoya disease: standard procedure and perioperative management","volume":"136","author":"Fujimura","year":"2025","unstructured":"Fujimura MIto MUchino HKawabori MSugiyama T.Efficacy and safety of combined revascularization surgery for moyamoya disease: standard procedure and perioperative management. Acta Neurochir Suppl. 2025;136:99-104."},{"issue":"5","key":"bib6","series-title":"Stroke","first-page":"1415","article-title":"Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult moyamoya Trial","volume":"45","author":"Miyamoto","year":"2014","unstructured":"Miyamoto SYoshimoto THashimoto NEffects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult moyamoya Trial. Stroke. 2014;45(5):1415-1421."},{"issue":"2","key":"bib7","series-title":"J Neurosurg","first-page":"432","article-title":"The frequency of postoperative stroke in moyamoya disease following combined revascularization: a single-university series and systematic review","volume":"121","author":"Kazumata","year":"2014","unstructured":"Kazumata KIto MTokairin KThe frequency of postoperative stroke in moyamoya disease following combined revascularization: a single-university series and systematic review. J Neurosurg. 2014;121(2):432-440."},{"issue":"3","key":"bib8","series-title":"Neurosurg Rev","first-page":"517","article-title":"Navigation-guided clipping of a de novo aneurysm associated with superficial temporal artery-middle cerebral artery bypass combined with indirect pial synangiosis in a patient with moyamoya disease","volume":"40","author":"Aburakawa","year":"2017","unstructured":"Aburakawa DFujimura MNiizuma KSakata HEndo HTominaga T.Navigation-guided clipping of a de novo aneurysm associated with superficial temporal artery-middle cerebral artery bypass combined with indirect pial synangiosis in a patient with moyamoya disease. Neurosurg Rev. 2017;40(3):517-521."},{"issue":"4","key":"bib9","series-title":"J Neurosurg Case Lessons","first-page":"CASE23665","article-title":"Spontaneous development and involution of a de novo pseudoaneurysm at the superficial temporal artery-middle cerebral artery bypass anastomotic site in a patient with moyamoya disease: illustrative case","volume":"7","author":"Ravina","year":"2024","unstructured":"Ravina KPatel BYim B.Spontaneous development and involution of a de novo pseudoaneurysm at the superficial temporal artery-middle cerebral artery bypass anastomotic site in a patient with moyamoya disease: illustrative case. J Neurosurg Case Lessons. 2024;7(4):CASE23665."},{"key":"bib10","series-title":"World Neurosurg","first-page":"583.e7","article-title":"De novo aneurysm associated with superficial temporal artery to middle cerebral artery bypass: report of two cases and review of literature","volume":"92","author":"Yokota","year":"2016","unstructured":"Yokota HYokoyama KNoguchi H.De novo aneurysm associated with superficial temporal artery to middle cerebral artery bypass: report of two cases and review of literature. World Neurosurg. 2016;92:583.e7-583.e12."},{"issue":"6","key":"bib11","series-title":"Acta Neurochir (Wien)","first-page":"1069","article-title":"Intracerebral hemorrhage caused by rupture of a giant aneurysm complicating superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease","volume":"152","author":"Eom","year":"2010","unstructured":"Eom KSKim DWKang SD.Intracerebral hemorrhage caused by rupture of a giant aneurysm complicating superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease. Acta Neurochir (Wien). 2010;152(6):1069-1073."},{"issue":"3","key":"bib12","series-title":"Surg Neurol","first-page":"261","article-title":"A ruptured middle cerebral artery aneurysm originating from the site of anastomosis 20 years after extracranial-intracranial bypass for moyamoya disease: case report","volume":"64","author":"Nishimoto","year":"2005","unstructured":"Nishimoto TYuki KSasaki TMurakami TKodama YKurisu K.A ruptured middle cerebral artery aneurysm originating from the site of anastomosis 20 years after extracranial-intracranial bypass for moyamoya disease: case report. Surg Neurol. 2005;64(3):261-265."},{"issue":"4","key":"bib13","series-title":"J Neurosurg","first-page":"1262","article-title":"Circumferential wall enhancement in evolving intracranial aneurysms on magnetic resonance vessel wall imaging","volume":"131","author":"Omodaka","year":"2019","unstructured":"Omodaka SEndo HNiizuma KCircumferential wall enhancement in evolving intracranial aneurysms on magnetic resonance vessel wall imaging. J Neurosurg. 2019;131(4):1262-1268."},{"issue":"6","key":"bib14","series-title":"Stroke","first-page":"1699","article-title":"Moyamoya vasculopathy and moyamoya-related systemic vasculopathy: a review with histopathological and genetic viewpoints","volume":"55","author":"Abumiya","year":"2024","unstructured":"Abumiya TFujimura M.Moyamoya vasculopathy and moyamoya-related systemic vasculopathy: a review with histopathological and genetic viewpoints. Stroke. 2024;55(6):1699-1706."},{"issue":"1","key":"bib15","series-title":"Neurol Med Chir (Tokyo)","first-page":"1","article-title":"Histological features of middle cerebral arteries from patients treated for moyamoya disease","volume":"47","author":"Takagi","year":"2007","unstructured":"Takagi YKikuta KNozaki KHashimoto N.Histological features of middle cerebral arteries from patients treated for moyamoya disease. Neurol Med Chir (Tokyo). 2007;47(1):1-4."},{"issue":"3","key":"bib16","series-title":"Virchows Arch A Pathol Anat Histol","first-page":"247","article-title":"Cerebral haemorrhage in moyamoya disease at autopsy","volume":"392","author":"Oka","year":"1981","unstructured":"Oka KYamashita MSadoshima STanaka K.Cerebral haemorrhage in moyamoya disease at autopsy. Virchows Arch A Pathol Anat Histol. 1981;392(3):247-261."},{"issue":"1","key":"bib17","series-title":"Tohoku J Exp Med","first-page":"45","article-title":"Current status of revascularization surgery for moyamoya disease: special consideration for its \u2018internal carotid-external carotid (IC-EC) conversion\u2019 as the physiological reorganization system","volume":"236","author":"Fujimura","year":"2015","unstructured":"Fujimura MTominaga T.Current status of revascularization surgery for moyamoya disease: special consideration for its \u2018internal carotid-external carotid (IC-EC) conversion\u2019 as the physiological reorganization system. Tohoku J Exp Med. 2015;236(1):45-53."},{"issue":"6","key":"bib18","series-title":"Neurol Med Chir (Tokyo)","first-page":"290","article-title":"Association between RNF213 p.R4810K and progression of cerebral artery negative remodeling in moyamoya disease","volume":"65","author":"Uchino","year":"2025","unstructured":"Uchino HIto MSugiyama TKurisu KFujima NFujimura M.Association between RNF213 p.R4810K and progression of cerebral artery negative remodeling in moyamoya disease. Neurol Med Chir (Tokyo). 2025;65(6):290-295."},{"issue":"3","key":"bib19","series-title":"Neurosurg Rev","first-page":"2305","article-title":"Impact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct\/indirect combined revascularization surgery for adult moyamoya disease","volume":"45","author":"Ito","year":"2022","unstructured":"Ito MKawabori MSugiyama TImpact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct\/indirect combined revascularization surgery for adult moyamoya disease. Neurosurg Rev. 2022;45(3):2305-2313."},{"issue":"11","key":"bib20","series-title":"Neurol Med Chir (Tokyo)","first-page":"1012","article-title":"Intracerebral hemorrhage from a ruptured aneurysm at the site of anastomosis 27 years after superficial temporal artery-middle cerebral artery bypass","volume":"50","author":"Hokari","year":"2010","unstructured":"Hokari MYasuda HIwasaki MIntracerebral hemorrhage from a ruptured aneurysm at the site of anastomosis 27 years after superficial temporal artery-middle cerebral artery bypass. 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