The significance of postbypass blood flow model in side to side bypass for moyamoya disease in predicting postoperative cerebral hyperperfusion syndrome.

Objective: We previously developed the use of side to side (s-s) bypass for the treatment of adult moyamoya disease (MMD) and discovered several kinds of distinct blood flow models intraoperatively, which we observed through indocyanine green-video angiography (ICG-VA). The purpose of this paper was to investigate the correlation between blood flow model (BFM) identified in s-s bypass and the incidence of postoperative cerebral hyperperfusion syndrome (CHS) among patients with MMD.

Methods: We analyzed 166 hemispheres from 153 patients diagnosed with MMD, including 118 hemispheres with s-s bypass and 48 with end to side (e-s) bypass.

Association of retrograde bypass flow depth along cortical recipient arteries with revascularization outcomes in direct bypass surgery for Moyamoya disease.

Objective: During the cerebral digital subtraction angiography (DSA) follow-up after direct bypass surgery in patients with Moyamoya disease (MMD), we observed different depths of retrograde bypass flow along the original middle cerebral artery (MCA) pathway into the intracranial cavity through the anastomosed recipient vessels. The aim of this study was to investigate the relationship between these varying depths of retrograde bypass flow and the outcomes of revascularization.

Methods: We conducted a retrospective study that included 109 patients (138 hemispheres) diagnosed with MMD and who underwent direct bypass surgery with subsequent DSA follow-up from 2022 to 2023.

Intraoperative evaluation of local cerebral hemodynamic change by laser speckle contrast imaging for predicting postoperative cerebral hyperperfusion during STA-MCA bypass in adult patients with moyamoya disease.

Cerebral hyperperfusion (CHP) occurred frequently after direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery for moyamoya disease (MMD). We analyzed cortical microvascular density (CMD) and the change of cerebral blood flow (LΔCBF) using intraoperative laser speckle contrast imaging (LSCI) on 130 hemispheres of 95 consecutive adult patients with MMD. The demographic characteristics, cortical hemodynamic sources, bypass methods, intraoperative blood flow data, and relative CBF changes on single-photon emission computed tomography (SPECT) examination (SΔrCBF) were compared between the groups with and without CHP.

Expression of hypoxia-inducing factor-1 and matrix metalloproteinase-9 in the recipient parasylvian cortical arteries with different hemodynamic sources in adult moyamoya disease.

Objective: In our latest research, we have demonstrated that the recipient parasylvian cortical arteries (PSCAs) with hemodynamic sources from the middle cerebral artery (M-PSCAs) has a higher risk of postoperative cerebral hyperperfusion (CHP) syndrome than those from non-M-PSCAs in adult moyamoya disease (MMD) patient. However, whether there are differences between M-PSCAs and non-M-PSCAs in vascular specimens characteristics has not been studied. In this study, we further investigate the vascular specimen of recipient PSCAs by histological and immunohistochemical methods.

A flow self-regulating superficial temporal artery-middle cerebral artery bypass based on side-to-side anastomosis for adult patients with moyamoya disease.

Objective: Side-to-side (S-S) superficial temporal artery-middle cerebral artery (STA-MCA) bypass was reportedly used to treat a special moyamoya disease (MMD) patient with collaterals arising from the donor STA. However, the S-S technique is not routinely performed to date, and its benefits are still unknown for adult MMD. The purpose of this study was to investigate the possibility of routine use of the S-S technique for adult MMD.