Long-term outcome of superficial temporal artery-middle cerebral artery bypass for patients with moyamoya disease in the US.


Journal Article

OBJECT: The authors report the long-term results of a series of direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass procedures in patients with moyamoya disease from the western US. METHODS: All patients with moyamoya disease treated at the University of Washington from 1990 through 2004 (39 patients) were included in this study. Patients underwent pre- and postoperative evaluation of cerebral perfusion dynamics. Surgical revascularization procedures were performed in all patients with impaired cerebral blood flow (CBF) findings. RESULTS: The mean age of patients at diagnosis was 34 years (range 10-55 years). All 39 patients had impaired CBF and/or vasomotor reserve and underwent revascularization procedures: 26 patients underwent bilateral operations, 13 unilateral (65 total procedures). An STA-MCA bypass was technically possible in 56 procedures (86.2%); saphenous vein interposition grafts were required in 3 procedures (4.6%); encephaloduroarteriosynangiosis was performed in 6 procedures (9.2%). Three patients died due to postoperative complications, yielding a procedure-related mortality rate of 4.61%, and 8 experienced non-life threatening complications (for a procedure-related rate of 12.3%). Long-term follow-up appeared to indicate a reduction in further ischemic events in surviving patients compared with the natural history. Cerebral perfusion dynamics improved postoperatively in all 36 surviving patients. CONCLUSIONS: Moyamoya disease may differ in the US and Asia, and STA-MCA bypass procedures may prevent future ischemic events in patients with this condition.

Full Text

Cited Authors

  • Mesiwala, AH; Sviri, G; Fatemi, N; Britz, GW; Newell, DW

Published Date

  • January 2008

Published In

Volume / Issue

  • 24 / 2

Start / End Page

  • E15 -

PubMed ID

  • 18275291

Pubmed Central ID

  • 18275291

Electronic International Standard Serial Number (EISSN)

  • 1092-0684

International Standard Serial Number (ISSN)

  • 1092-0684

Digital Object Identifier (DOI)

  • 10.3171/foc/2008/24/2/e15


  • eng