Pedicled temporoparietal fascial flap for combined revascularization in adult moyamoya disease.

Ravina, Kristine; Rennert, Robert C; Strickland, Ben A; Chien, Mark; Carey, Joseph N; Russin, Jonathan J · J Neurosurg · 2019

case_series · Level IV

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Abstract

Moyamoya disease (MMD) is a progressive, idiopathic cerebrovascular occlusive disease. Various revascularization techniques including direct, indirect, and combined microvascular bypasses have been described. This article presents a modified revascularization technique for MMD utilizing a pedicled temporoparietal fascial flap (TPFF) for combined revascularization. This technique combines a large area of coverage for indirect revascularization with the benefits of a direct bypass. The pedicled TPFF also benefits from intact venous drainage to minimize the risk of flap swelling that could result in complications from mass effect.