The clinical effect of superficial temporal artery-middle cerebral artery bypass combining with encephalo-duroarterio-synangiosis in the treatment of moyamoya disease

Abstract

Objective To explore clinical curative effects of superficial temporal artery-middle cerebral artery bypass combining with encephalo-duroarterio-synangiosis(STA-MCA+ EDMS) in the treatment of moyamoya disease. Methods Thirteen cases were confirmed to be moyamoya disease by digital subtraction angiography (DSA), and treated with STA-MCA+ EDMS methods. Four cases were ischemic, and the others were hemorrhagic in this group. Results The follow-up was 6-12 months. The clinical symptoms were improved significantly, without cerebral ischemic attack in 4 ischemic cases. Seven hemorrhagic cases got blood from the external carotid artery by means of vascular bypass or temporal muscle, and established effective collateral circulation half a year after operation. Two hemorrhagic cases bleed again in July after operation. However, the family gave up treatment. Ten cases were good, one case was moderate, while two cases got bad. The total effective rate was 76.9%. Conclusions STA-MCA+ EDMS can improve cerebral hemodynamics of moyamoya disease, improve quality of life, and reduce incidence of stroke. Key words: Moyamoya disease/SU; Cerebral revascularization; Middle cerebral artery/SU; Temporal arteries/SU