Outcome Following Surgical Revascularization in Patients of Moyamoya Disease with Focus on Graft Patency and Angiographic Changes (original) (raw)

Neurology India, 2021

Abstract

Background: Surgical revascularization is the mainstay of treatment in symptomatic patients of moyamoya disease (MMD). Objective: The present study analyzed the postoperative angio-architecture in pediatric and adult patients of moyamoya disease. Material and Methods: 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). Results: Eighty-two patients underwen...

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