Outcomes after superficial temporal artery–middle cerebral artery anastomosis combined with multiple burr hole surgery and dural inversion synangiosis for moyamoya disease in adults

Autor: Dongxiao Xu, Bingjie Zheng, Qiaowei Wu, Jinbiao Yao, Tatiana Ilyasova, Aferin Beilerli, Huaizhang Shi
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Surgery, Vol 9 (2022)
Druh dokumentu: article
ISSN: 2296-875X
DOI: 10.3389/fsurg.2022.1047727
Popis: ObjectiveSeveral forms of cerebral revascularization have been carried out to treat moyamoya disease, however, the existing methods are accompanied by a variety of complications. In this study, the authors aimed to evaluate the clinical and angiographic outcomes of a new surgical procedure: superficial temporal artery–middle cerebral artery (STA-MCA) anastomosis combined with multiple burr hole (MBH) surgery and dural inversion synangiosis for the treatment of moyamoya disease in adults.MethodsPatients treated for moyamoya disease from August 2019 to July 2021 were retrospectively reviewed. Clinical data, including perioperative complications and follow-up outcomes, were noted. Preoperative and postoperative angiograms were compared, and the diameters of the frontal branch of the superficial temporal artery (F-STA), the deep temporal artery (DTA), the distal superficial temporal artery (STA) before the bifurcation and the middle meningeal artery (MMA) were measured on preoperative and postoperative angiograms. Meanwhile, a Matsushima score was assigned from postoperative angiograms.ResultsThis study included 66 patients (67 hemispheres). During the follow-up period, a median of 18 (IQR, 13–21) months, no stroke or death occurred in any of the patients. The clinical outcomes were excellent in 27 patients (40.9%), good in 34 patients (51.6%), fair in 4 patients (6.0%), and poor in 1 patient (1.5%); the overall rate of favorable clinical outcomes (excellent and good) was 92.5%. The modified Rankin Scale (mRS) score was significantly improved at follow-up (P
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