{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:40:09Z","timestamp":1793418009228,"version":"4.5.0"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2008,2]]},"abstract":"\n Object<\/jats:title>\n The authors report the long-term results of a series of direct superficial temporal artery\u2013middle cerebral artery (STA\u2013MCA) bypass procedures in patients with moyamoya disease from the western US.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n All patients with moyamoya disease treated at the University of Washington from 1990 through 2004 (39 patients) were included in this study. Patients underwent pre- and postoperative evaluation of cerebral perfusion dynamics. Surgical revascularization procedures were performed in all patients with impaired cerebral blood flow (CBF) findings.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean age of patients at diagnosis was 34 years (range 10\u201355 years). All 39 patients had impaired CBF and\/or vasomotor reserve and underwent revascularization procedures: 26 patients underwent bilateral operations, 13 unilateral (65 total procedures). An STA\u2013MCA bypass was technically possible in 56 procedures (86.2%); saphenous vein interposition grafts were required in 3 procedures (4.6%); encephaloduroarteriosynangiosis was performed in 6 procedures (9.2%). Three patients died due to postoperative complications, yielding a procedure-related mortality rate of 4.61%, and 8 experienced non\u2013life threatening complications (for a procedure-related rate of 12.3%). Long-term follow-up appeared to indicate a reduction in further ischemic events in surviving patients compared with the natural history. Cerebral perfusion dynamics improved postoperatively in all 36 surviving patients.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Moyamoya disease may differ in the US and Asia, and STA\u2013MCA bypass procedures may prevent future ischemic events in patients with this condition.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/foc\/2008\/24\/2\/e15","type":"journal-article","created":{"date-parts":[[2008,2,14]],"date-time":"2008-02-14T15:12:19Z","timestamp":1203001939000},"page":"E15","source":"Crossref","is-referenced-by-count":112,"title":["Long-term outcome of superficial temporal artery\u2013middle cerebral artery bypass for patients with moyamoya disease in the US"],"prefix":"10.3171","volume":"24","author":[{"given":"Ali H.","family":"Mesiwala","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gill","family":"Sviri","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Fatemi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin W.","family":"Britz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Newell","sequence":"additional","affiliation":[{"name":"Neurosciences Institute, Swedish Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0240015","series-title":"Stroke","first-page":"1347","article-title":"Clinical features of moyamoya disease in the United States","volume":"29","author":"Chiu","year":"1998"},{"issue":"Suppl 2","key":"b2-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S36","article-title":"Midwest experience with moyamoya disease","volume":"99","author":"Edwards-Brown","year":"1997"},{"issue":"Suppl 47","key":"b3-0240015","series-title":"Ann Clin Res","first-page":"21","article-title":"The treatment of Moyamoya disease by superficial temporal-middle cerebral artery (STA-MCA) anastomosis","volume":"18","author":"Erickson","year":"1986"},{"issue":"Suppl 2","key":"b4-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S194","article-title":"The efficacy of bypass surgery for the patients with hemorrhagic moyamoya disease","volume":"99","author":"Fujii","year":"1997"},{"key":"b5-0240015","series-title":"Surg Neurol","first-page":"138","article-title":"Current state of study on moyamoya disease in Japan","volume":"47","author":"Fukui","year":"1997"},{"key":"b6-0240015","series-title":"Stroke","first-page":"1342","article-title":"Surgical therapy for adult moyamoya disease. Can surgical revascularization prevent the recurrence of intracerebral hemorrhage?","volume":"27","author":"Houkin","year":"1996"},{"key":"b7-0240015","series-title":"Acta Neurochir (Wien)","first-page":"269","article-title":"Neovascularization (angiogenesis) after revascularization in moyamoya disease. Which technique is most useful for moyamoya disease?","volume":"142","author":"Houkin","year":"2000"},{"key":"b8-0240015","series-title":"Radiat Med","first-page":"225","article-title":"SPECT measurements of cerebral blood volume before and after acetazolamide in occlusive cerebrovascular diseases","volume":"12","author":"Inoue","year":"1994"},{"key":"b9-0240015","series-title":"Neurosurgery","first-page":"1157","article-title":"Direct revascularization to the anterior cerebral artery territory in patients with moyamoya disease: report of five cases","volume":"42","author":"Iwama","year":"1998"},{"issue":"Suppl 2","key":"b10-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S134","article-title":"Superficial temporal artery to anterior cerebral artery direct anastomosis in patients with moyamoya disease","volume":"99","author":"Iwama","year":"1997"},{"key":"b11-0240015","series-title":"J Neurosurg","first-page":"679","article-title":"Treatment of moyamoya disease with STA-MCA anastomosis","volume":"49","author":"Karasawa","year":"1978"},{"key":"b12-0240015","series-title":"Neurol Res","first-page":"113","article-title":"EC-IC bypass for adult patients with moyamoya disease","volume":"13","author":"Kobayashi","year":"1991"},{"key":"b13-0240015","series-title":"Acta Neurochir (Wien)","first-page":"135","article-title":"Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS)","volume":"98","author":"Matsushima","year":"1989"},{"key":"b14-0240015","series-title":"Neurosurgery","first-page":"401","article-title":"Surgical treatment of moyamoya disease in pediatric patients\u2014comparison between the results of indirect and direct revascularization procedures","volume":"31","author":"Matsushima","year":"1992"},{"key":"b15-0240015","series-title":"Neurol Res","first-page":"32","article-title":"Revascularization surgery for moyamoya disease","volume":"10","author":"Nakagawa","year":"1988"},{"issue":"Suppl 2","key":"b16-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S156","article-title":"Long-term results of surgically treated moyamoya disease","volume":"99","author":"Nakashima","year":"1997"},{"key":"b17-0240015","series-title":"Stroke","first-page":"625","article-title":"Effectiveness of superficial temporal artery-middle cerebral artery anastomosis in adult moyamoya disease: cerebral hemodynamics and clinical course in ischemic and hemorrhagic varieties","volume":"29","author":"Okada","year":"1998"},{"key":"b18-0240015","series-title":"J Vasc Tech","first-page":"163","article-title":"Use of cerebral vasoreactivity testing in the evaluation of moyamoya disease","volume":"24","author":"Olsen","year":"2000"},{"key":"b19-0240015","series-title":"Anesth Analg","first-page":"1060","article-title":"Risk factors for neurologic deterioration after revascularization surgery in patients with moyamoya disease","volume":"85","author":"Sakamoto","year":"1997"},{"key":"b20-0240015","series-title":"J Neurosurg","first-page":"142","article-title":"Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis","volume":"100","author":"Scott","year":"2004"},{"key":"b21-0240015","series-title":"Neurosurg Clin N Am","first-page":"585","article-title":"Cerebral revascularization for moyamoya disease in adults","volume":"12","author":"Srinivasan","year":"2001"},{"key":"b22-0240015","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease","volume":"20","author":"Suzuki","year":"1969"},{"key":"b23-0240015","series-title":"Neurosurgery","first-page":"324","article-title":"Surgical treatment for pediatric moyamoya disease: use of the superficial temporal artery for both areas supplied by the anterior and middle cerebral arteries","volume":"40","author":"Suzuki","year":"1997"},{"key":"b24-0240015","series-title":"No To Shinkei","first-page":"37","article-title":"Hypogenesis of bilateral internal carotid arteries","volume":"9","author":"Takeuchi","year":"1957"},{"key":"b25-0240015","series-title":"Neurol Med Chir","first-page":"420","article-title":"Hyper-perfusion syndrome after extracranial-intracranial bypass in a patient with moyamoya disease\u2014case report","volume":"38","author":"Uno","year":"1998"},{"key":"b26-0240015","series-title":"Neuroradiology","first-page":"217","article-title":"The effect of EC-IC bypass surgery on resting cerebral blood flow and cerebrovascular reserve capacity studied with stable XE-CT and acetazolamide test","volume":"33","author":"Yamashita","year":"1991"},{"key":"b27-0240015","series-title":"Microsurgical Anastomosis for Cerebral Ischemia","first-page":"272","article-title":"Revascularization in children with moyamoya disease: low-density area and regional cerebral blood flow after operation","author":"Yonekawa","year":"1985"},{"issue":"Suppl 2","key":"b28-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S58","article-title":"Moyamoya disease in Europe, past and present status","volume":"99","author":"Yonekawa","year":"1997"},{"key":"b29-0240015","series-title":"Annual Report (1988) of the Research Committee on the Spontaneous Occlusion of the Circle of Willis","first-page":"81","article-title":"Clinical features of hemorrhagic type moyamoya disease: special emphasis on cases with rebleeding","author":"Yonekawa","year":"1988"},{"key":"b1-0240015","series-title":"Stroke","first-page":"1347","article-title":"Clinical features of moyamoya disease in the United States","volume":"29","author":"Chiu","year":"1998"},{"issue":"Suppl 2","key":"b2-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S36","article-title":"Midwest experience with moyamoya disease","volume":"99","author":"Edwards-Brown","year":"1997"},{"issue":"Suppl 47","key":"b3-0240015","series-title":"Ann Clin Res","first-page":"21","article-title":"The treatment of Moyamoya disease by superficial temporal-middle cerebral artery (STA-MCA) anastomosis","volume":"18","author":"Erickson","year":"1986"},{"issue":"Suppl 2","key":"b4-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S194","article-title":"The efficacy of bypass surgery for the patients with hemorrhagic moyamoya disease","volume":"99","author":"Fujii","year":"1997"},{"key":"b5-0240015","series-title":"Surg Neurol","first-page":"138","article-title":"Current state of study on moyamoya disease in Japan","volume":"47","author":"Fukui","year":"1997"},{"key":"b6-0240015","series-title":"Stroke","first-page":"1342","article-title":"Surgical therapy for adult moyamoya disease. Can surgical revascularization prevent the recurrence of intracerebral hemorrhage?","volume":"27","author":"Houkin","year":"1996"},{"key":"b7-0240015","series-title":"Acta Neurochir (Wien)","first-page":"269","article-title":"Neovascularization (angiogenesis) after revascularization in moyamoya disease. Which technique is most useful for moyamoya disease?","volume":"142","author":"Houkin","year":"2000"},{"key":"b8-0240015","series-title":"Radiat Med","first-page":"225","article-title":"SPECT measurements of cerebral blood volume before and after acetazolamide in occlusive cerebrovascular diseases","volume":"12","author":"Inoue","year":"1994"},{"key":"b9-0240015","series-title":"Neurosurgery","first-page":"1157","article-title":"Direct revascularization to the anterior cerebral artery territory in patients with moyamoya disease: report of five cases","volume":"42","author":"Iwama","year":"1998"},{"issue":"Suppl 2","key":"b10-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S134","article-title":"Superficial temporal artery to anterior cerebral artery direct anastomosis in patients with moyamoya disease","volume":"99","author":"Iwama","year":"1997"},{"key":"b11-0240015","series-title":"J Neurosurg","first-page":"679","article-title":"Treatment of moyamoya disease with STA-MCA anastomosis","volume":"49","author":"Karasawa","year":"1978"},{"key":"b12-0240015","series-title":"Neurol Res","first-page":"113","article-title":"EC-IC bypass for adult patients with moyamoya disease","volume":"13","author":"Kobayashi","year":"1991"},{"key":"b13-0240015","series-title":"Acta Neurochir (Wien)","first-page":"135","article-title":"Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS)","volume":"98","author":"Matsushima","year":"1989"},{"key":"b14-0240015","series-title":"Neurosurgery","first-page":"401","article-title":"Surgical treatment of moyamoya disease in pediatric patients\u2014comparison between the results of indirect and direct revascularization procedures","volume":"31","author":"Matsushima","year":"1992"},{"key":"b15-0240015","series-title":"Neurol Res","first-page":"32","article-title":"Revascularization surgery for moyamoya disease","volume":"10","author":"Nakagawa","year":"1988"},{"issue":"Suppl 2","key":"b16-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S156","article-title":"Long-term results of surgically treated moyamoya disease","volume":"99","author":"Nakashima","year":"1997"},{"key":"b17-0240015","series-title":"Stroke","first-page":"625","article-title":"Effectiveness of superficial temporal artery-middle cerebral artery anastomosis in adult moyamoya disease: cerebral hemodynamics and clinical course in ischemic and hemorrhagic varieties","volume":"29","author":"Okada","year":"1998"},{"key":"b18-0240015","series-title":"J Vasc Tech","first-page":"163","article-title":"Use of cerebral vasoreactivity testing in the evaluation of moyamoya disease","volume":"24","author":"Olsen","year":"2000"},{"key":"b19-0240015","series-title":"Anesth Analg","first-page":"1060","article-title":"Risk factors for neurologic deterioration after revascularization surgery in patients with moyamoya disease","volume":"85","author":"Sakamoto","year":"1997"},{"key":"b20-0240015","series-title":"J Neurosurg","first-page":"142","article-title":"Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis","volume":"100","author":"Scott","year":"2004"},{"key":"b21-0240015","series-title":"Neurosurg Clin N Am","first-page":"585","article-title":"Cerebral revascularization for moyamoya disease in adults","volume":"12","author":"Srinivasan","year":"2001"},{"key":"b22-0240015","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease","volume":"20","author":"Suzuki","year":"1969"},{"key":"b23-0240015","series-title":"Neurosurgery","first-page":"324","article-title":"Surgical treatment for pediatric moyamoya disease: use of the superficial temporal artery for both areas supplied by the anterior and middle cerebral arteries","volume":"40","author":"Suzuki","year":"1997"},{"key":"b24-0240015","series-title":"No To Shinkei","first-page":"37","article-title":"Hypogenesis of bilateral internal carotid arteries","volume":"9","author":"Takeuchi","year":"1957"},{"key":"b25-0240015","series-title":"Neurol Med Chir","first-page":"420","article-title":"Hyper-perfusion syndrome after extracranial-intracranial bypass in a patient with moyamoya disease\u2014case report","volume":"38","author":"Uno","year":"1998"},{"key":"b26-0240015","series-title":"Neuroradiology","first-page":"217","article-title":"The effect of EC-IC bypass surgery on resting cerebral blood flow and cerebrovascular reserve capacity studied with stable XE-CT and acetazolamide test","volume":"33","author":"Yamashita","year":"1991"},{"key":"b27-0240015","series-title":"Microsurgical Anastomosis for Cerebral Ischemia","first-page":"272","article-title":"Revascularization in children with moyamoya disease: low-density area and regional cerebral blood flow after operation","author":"Yonekawa","year":"1985"},{"issue":"Suppl 2","key":"b28-0240015","series-title":"Clin Neurol Neurosurg","first-page":"S58","article-title":"Moyamoya disease in Europe, past and present status","volume":"99","author":"Yonekawa","year":"1997"},{"key":"b29-0240015","series-title":"Annual Report (1988) of the Research Committee on the Spontaneous Occlusion of the Circle of Willis","first-page":"81","article-title":"Clinical features of hemorrhagic type moyamoya disease: special emphasis on cases with rebleeding","author":"Yonekawa","year":"1988"}],"container-title":["Neurosurgical 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