{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:58:40Z","timestamp":1787497120829,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Indirect bypass surgeries for moyamoya disease have included modifications of procedures involving placement of the superficial temporal artery on the brain pial surface. We evaluate the functional and angiographic outcomes of patients treated with encephaloduroarteriomyosynangiosis (indirect) revascularization and examine the outcome in relation to demographic and radiological factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients treated surgically for moyamoya disease over a 14-year period were identified. Demographics, clinical presentation, and radiology were analyzed to assign a stage for the disease (Suzuki staging) and the extent of revascularization (Matsushima grade) at the last follow-up. A modified Rankin score was used to assess the clinical status at presentation and the functional outcome at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 46 patients operated on by a single surgeon over a 14-year period. A higher incidence of motor deficits, seizures, and speech deficits was seen in the pediatric population. Age, sex, preoperative Suzuki disease stage, and hemispheric involvement had no bearing on angiographic outcome at last follow-up. Three of 46 patients (6.5%) developed immediate postoperative complications. Among 43 patients on follow-up, 39 had stable disease or showed improvement in clinical symptoms with 90% event-free status at last follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Indirect revascularization procedures are an effective alternative to direct cerebral revascularizations in the early or advanced stages of moyamoya disease. This is effective in a predominant ischemic presentation as noted in our series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.329538","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T15:13:14Z","timestamp":1725721994000},"page":"1259-1264","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Surgical Outcome of Encephaloduroarteriomyosynangiosis for Moyamoya Disease"],"prefix":"10.4103","volume":"69","author":[{"given":"Sunil V","family":"Furtado","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eilene","family":"Basu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anish","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Neurology, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuldeep","family":"Vala","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilip","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sri Sathya Sai Insitute of Higher Medical Sciences, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10,30]]},"reference":[{"key":"R1-20250925","doi-asserted-by":"crossref","first-page":"927","DOI":"10.3171\/2009.4.JNS081649","article-title":"Clinical outcome after 450 revascularization procedures for moyamoya disease","volume":"111","author":"Guzman","year":"2009","journal-title":"J Neurosurg"},{"issue":"Suppl 1","key":"R2-20250925","first-page":"78","article-title":"Moyamoya disease: Experience with direct and indirect revascularization in 70 patients from a nonendemic region","volume":"64","author":"Sadashiva","year":"2016","journal-title":"Neurol India"},{"key":"R3-20250925","doi-asserted-by":"crossref","first-page":"976","DOI":"10.3171\/jns.2000.93.6.0976","article-title":"Long-term natural history of hemorrhagic moyamoya disease in 42 patients","volume":"93","author":"Kobayashi","year":"2000","journal-title":"J Neurosurg"},{"key":"R4-20250925","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.3171\/2014.7.JNS132434","article-title":"Outcome in adult patients with hemorrhagic moyamoya disease after combined extracranial-intracranial bypass","volume":"121","author":"Jiang","year":"2014","journal-title":"J Neurosurg"},{"key":"R5-20250925","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1136\/jnnp-2012-302236","article-title":"Long term outcome after conservative and surgical treatment of haemorrhagic moyamoya disease","volume":"84","author":"Liu","year":"2013","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R6-20250925","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/neuros\/nyz074","article-title":"Functional outcomes after revascularization procedures in patients with hemorrhagic moyamoya disease","volume":"86","author":"Abhinav","year":"2020","journal-title":"Neurosurgery"},{"key":"R7-20250925","doi-asserted-by":"crossref","first-page":"3177","DOI":"10.1161\/STROKEAHA.119.025609","article-title":"Long-term outcomes of indirect bypass for 629 children with moyamoya disease: Longitudinal and cross-sectional analysis","volume":"50","author":"Ha","year":"2019","journal-title":"Stroke"},{"key":"R8-20250925","first-page":"9","article-title":"Moyamoya disease versus moyamoya syndrome: Comparison of presentation and outcome in 338 hemispheres","volume":"1","author":"Feghali","year":"2019","journal-title":"J Neurosurg"},{"key":"R9-20250925","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1227\/00006123-199209000-00003","article-title":"Surgical treatment of moyamoya disease in pediatric patients\u2014 comparison between the results of indirect and direct revascularization procedures","volume":"31","author":"Matsushima","year":"1992","journal-title":"Neurosurgery"},{"key":"R10-20250925","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.nec.2017.02.004","article-title":"Direct versus indirect bypass for moyamoya disease","volume":"28","author":"Liu","year":"2017","journal-title":"Neurosurg Clin N Am"},{"key":"R12-20250925","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1001\/archneur.1969.00480090076012","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. 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