TABLE 3.
Literature Review of Salvage Revascularization Surgery Options and Their Outcomes for Moyamoya Disease
| Paper | Country | Intervention | No. of patients (no. of hemispheres) | Neurological outcome | Mean follow-up | Complications |
|---|---|---|---|---|---|---|
| Cahan30 | USA | Direct STA-MCA bypass | 1 (1) | No new ischemic symptoms | 1 y | None |
| Miyamoto et al31 | Japan | Direct (STA-MCA or OA-MCA) bypass with EMS (16), omental transposition (3) | 11 (19) | Complete resolution of TIAs and improved motor and intellectual function in 10 of 11 patients (91%) | NRa | None |
| Matsushima et al32 | Japan | EMS (2), EMAS (1) | 3 (3) | Complete resolution of TIAs in 2 of 3 patients (67%), 1 markedly decreased TIAs which gradually disappeared | NR | None |
| Touho et al33 | Japan | Direct STA-MCA bypass with or without EMS | 31 (28) | Clinical improvement in 27 of 28 patients with complete resolution of TIAs (96%), 1 patient with fixed deficit unchanged | 42.4 mo | None |
| Touho et al34 | Japan | Omental transplantation | 5 | Complete resolution of TIAs in 4 of 5 patients (80%), continued but markedly decreased TIAs in 1 patient | 15.2 mo | None |
| Hayashi et al35 | Japan | Direct OA-PCA bypass with EGDS and burr holes | 3 (3) | Complete resolution of TIAs in 3 of 3 patients (67%) | 9 mo | 1 patient with “transient visual impairment” in the early postoperative period for 1 mo because of cerebral edema |
| Pandey and Steinberg36 | USA | Direct (STA-MCA, OA-PCA, or OA-MCA) bypass (14) or EMS (4) or repeat EDAS (2) or omental transposition (3) | 16 (23) | 12 patients (80%) had no TIA or strokes, 2 patients with occasional TIAs (before surgery), 1 patient had frequent TIAs/failed anastomsis and had rpt EMS with burr holes | 34 mo | Death due to reperfusion hemorrhage from high-flow vein graft |
| Navarro et al37 | USA | Laparoscopic pedicle omental transposition | 3 (4) | Complete resolution of ischemic symptoms in 3 of 3 patients (100%) | 1 y | None |
| Hori et al38 | Germany | Radial artery graft ECA-MCA bypass | 4 (4) | Complete resolution of TIAs and/or stroke in 4 of 4 patients, 1 patient had graft failure but transdural collaterals had formed | 8.5 mo | None |
ECA, external carotid artery; EGDS, encephalogaleodurosynangiosis; EMAS, encephalomyoarterial-synangiosis; EMS, encephalo-myo-synangiosis; MCA, middle cerebral artery; OA, occipital artery; PCA, posterior cerebral artery; STA, superficial temporal artery; TIA, transient ischemic attack.
a
NR means information not reported.