How I do it - extracranial-intracranial bypass surgery integrating STA-MCA anastomosis, synangiosis, MMA supply, and preservation of recipient artery perforators: the Integrated Method.
other · Level V
Where this comes from
- Record sourced from PubMed, PMID 41045365.
- Also identified by DOI 10.1007/s00701-025-06689-z and PMC identifier 12496275.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Extracranial-intracranial (EC-IC) bypass is an effective revascularization technique for flow augmentation in conditions like Moyamoya disease and ischemic cerebrovascular disorders. The approach described here combines direct bypass (STA-MCA anastomosis), indirect bypass (encephaloduromyosynangiosis, EDMS), preservation of the middle meningeal artery (MMA), and preservation of recipient artery perforators to optimize outcomes. This article outlines a comprehensive surgical strategy emphasizing anatomical considerations, procedural nuances, and the integration of direct and indirect techniques while preserving MMA and recipient artery perforators to augment collateral circulation. The Integrated Method described here encompasses four technical aspects so as to enhance revascularization, minimize complications, and improve long-term outcome in carefully selected patients.
Medical subject headings
- Cerebral Revascularization
- Meningeal Arteries
- Middle Cerebral Artery
- Moyamoya Disease