{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T15:09:00Z","timestamp":1774537740683,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81771304"],"award-info":[{"award-number":["81771304"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005227","name":"Jilin Department of Health","doi-asserted-by":"publisher","award":["2019SCZ037"],"award-info":[{"award-number":["2019SCZ037"]}],"id":[{"id":"10.13039\/501100005227","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009991","name":"Department of Finance of Jilin Province","doi-asserted-by":"publisher","award":["20200201623JC"],"award-info":[{"award-number":["20200201623JC"]}],"id":[{"id":"10.13039\/501100009991","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The efficacy of indirect revascularization vs. non-surgical treatment in adults with Moyamoya disease (MMD) and Moyamoya syndrome (MMS) remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the clinical outcomes of indirect revascularization and non-surgical treatments in adult patients with MMD and MMS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected medical records and follow-up results of adult patients with MMD and MMS who received treatment in the China-Japan Union Hospital of Jilin University between January 2019 and December 2021. A Shapiro\u2013Wilk test, independent sample <jats:italic>t<\/jats:italic>-test or Mann-Whitney U-test, and Pearson chi-square test were used to compare baseline variables. The propensity-score analysis was used to compare clinical outcomes of patients with MMD and MMS who underwent indirect revascularization and non-surgical treatments. The color-coded digital subtraction angiography (CC-DSA) was used to quantitatively analyzed the preoperative and postoperative (at 6-month follow-up) images of patients in the surgical group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 144 patients were included in this study, of whom 37 received indirect revascularization treatment and 107 received non-surgical treatment. The average age of the patients was 58.3 \u00b1 13.4 years. Perioperative complications were observed in eight of the operations. During the follow-up period, a total of 35 stroke events occurred, including two cases (5.4%) in the surgery group and 33 cases (30.8%) in the non-surgery group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The preoperative mean transit time (MTT) of bypass vessel (superficial temporal artery, STA) was 0.26 \u00b1 0.07, and the postoperative MTT of bypass vessel was 3.0 \u00b1 0.25, and there was no statistical difference between the subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Indirect revascularization surgery can significantly reduce the recurrent stroke incidence of MMD and MMS patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.1041886","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T05:30:00Z","timestamp":1671427800000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Indirect revascularization vs. non-surgical treatment for Moyamoya disease and Moyamoya syndrome: A comparative effectiveness study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yixuan","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s10143-018-0994-5","article-title":"Progress in moyamoya disease","volume":"43","author":"Shang","year":"2020","journal-title":"Neurosurg Rev."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2","DOI":"10.5853\/jos.2015.01627","article-title":"Moyamoya disease: epidemiology, clinical features, and diagnosis","volume":"18","author":"Kim","year":"2016","journal-title":"J 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