{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:23:04Z","timestamp":1787775784471,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgical revascularization is the mainstay of treatment in symptomatic patients of moyamoya disease (MMD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The present study analyzed the postoperative angio-architecture in pediatric and adult patients of moyamoya disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>Patients with MMD, both ischemic and hemorrhagic, were subjected to surgery. A superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis was attempted in all. It was augmented by an encephalo-duro-myo-synangiosis), this was labelled as the combined surgical group. In patients where a direct bypass was not possible encephalo-duro-arterio-myo-synangiosis (EDAMS) was performed and these patients were put in the indirect surgery group. In the postoperative period, MRA was performed in all patients to look for (a) graft patency, (b) regression of moyamoya vessels, and (c) degree of surgical neovascularization (as quantified on adapted Matsushima and Inaba grading system).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-two patients underwent 131 surgical revascularization procedures. A combined surgery (STA-MCA bypass and EDAMS) was performed in 100 hemispheres and indirect surgery (EDAMS) on 31 sides. In children less than 5 years of age, STA-MCA anastomosis was possible in more than 50% of patients. Clinical improvement was seen in 85.4% of patients. Postoperative MRA demonstrated a patent bypass graft in 97% of cases. Regression of moyamoya vessels was seen in half of the cases and good surgical revascularization (type A and B) was seen in more than 80% of hemispheres in the combined surgery and indirect surgery group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Revascularization procedures led to a regression of moyamoya collaterals, appearance of surgical neo angiogenesis, and a graft patency rate of 97%. Surgical group with combined revascularization had a trend towards better collateral development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.319228","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T02:21:28Z","timestamp":1640658088000},"page":"620-627","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Outcome Following Surgical Revascularization in Patients of Moyamoya Disease with Focus on Graft Patency and Angiographic Changes"],"prefix":"10.4103","volume":"69","author":[{"given":"Sunil K","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajashekhar","family":"Narayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Aggarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju","family":"Mohanty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag","family":"Ahuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Verma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kokkula","family":"Praneeth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-17-20240907","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2009.1.FOCUS08310","article-title":"Moyamoya disease: A summary","volume":"26","author":"Burke","year":"2009","journal-title":"Neurosurg Focus"},{"key":"R3-17-20240907","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1161\/STROKEAHA.117.018563","article-title":"Surgical management of moyamoya disease","volume":"49","author":"Acker","year":"2018","journal-title":"Stroke"},{"key":"R4-17-20240907","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.1016\/j.wneu.2018.04.076","article-title":"Longterm outcomes after encephaloduroarteriosynangiosis in adult patients with moyamoya disease presenting with ischemia","volume":"115","author":"Bao","year":"2018","journal-title":"World Neurosurg"},{"key":"R5-17-20240907","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.neuchi.2017.08.005","article-title":"Clinical analysis of combined revascularization in treating ischemic Moyamoya disease in adults","volume":"64","author":"Chen","year":"2018","journal-title":"Neurochirurgie"},{"key":"R6-17-20240907","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1093\/neuros\/nyy114","article-title":"Treatment of moyamoya disease","volume":"65","author":"Deng","year":"2018","journal-title":"Neurosurgery"},{"key":"R7-17-20240907","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1620\/tjem.236.45","article-title":"Current status of revascularization surgery for Moyamoya disease: Special consideration for its 'internal carotid-external carotid (IC-EC) conversion' as the physiological reorganization system","volume":"236","author":"Fujimura","year":"2015","journal-title":"Tohoku J Exp Med"},{"key":"R8-17-20240907","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s00381-004-1118-9","article-title":"Revascularisation surgery for paediatric moyamoya: A review of the literature","volume":"21","author":"Fung","year":"2005","journal-title":"Childs Nerv Syst"},{"key":"R9-17-20240907","doi-asserted-by":"crossref","first-page":"927","DOI":"10.3171\/2009.4.JNS081649","article-title":"Clinical outcome after 450 revascularization procedures for moyamoya disease. 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