Abstract
Recent animal experimental and human autopsy studies have revealed that the mechanism of indirect bypass surgery is the induction of “arteriogenesis,” the main trigger of which is the inter-tissue gradient of perfusion pressure. Knowing this helps us to understand why indirect bypass surgery is effective for the chronic ischemic condition of moyamoya disease, how better to apply this technique, and what this technique’s limitations are.
In this chapter, we review various aspects of the use of indirect bypass surgery for moyamoya disease. As part of our discussion, the characteristic hemodynamic condition of moyamoya disease is summarized. Special emphasis is placed on the importance of using clinical imaging for precise measurement of regional cerebral perfusion pressures, so that indirect bypass surgery can be most effectively used for the treatment of moyamoya disease.
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References
Matsushima Y, Fukai N, Tanaka K, Tsuruoka S, Inaba Y, Aoyagi M, Ohno K. A new surgical treatment of moyamoya disease in children: a preliminary report. Surg Neurol. 1981;15:313–20.
Mukawa M, Nariai T, Matsushima Y, Tanaka Y, Inaji M, Maehara T, Aoyagi M, Ohno K. Long-term follow-up of surgically treated juvenile patients with moyamoya disease. J Neurosurg Pediatr. 2012;10:451–6.
Henschen C. [surgical revascularization of cerebral injury of circulatory origin by means of stratification of pedunculated muscle flaps]. Langenbecks Archiv fur klinische Chirurgie vereinigt mit deutsche Zeitschrift fur. Chirurgie. 1950;264:392–401.
Goldsmith HS, Chen WF, Duckett SW. Brain vascularization by intact omentum. Arch Surg. 1973;106:695–8.
Yonekawa Y, Yasargil MG. Brain vascularization by transplanted omentum: a possible treatment of cerebral ischemia. Neurosurgery. 1977;1:256–9.
Karasawa J, Kikuchi H, Furuse S, Sakaki T, Yoshida Y. A surgical treatment of “moyamoya” disease “encephalo-myo synangiosis”. Neurol Med Chir. 1977;17:29–37.
Karasawa J, Kikuchi H, Kawamura J, Sakai T. Intracranial transplantation of the omentum for cerebrovascular moyamoya disease: a two-year follow-up study. Surg Neurol. 1980;14:444–9.
Endo M, Kawano N, Miyaska Y, Yada K. Cranial burr hole for revascularization in moyamoya disease. J Neurosurg. 1989;71:180–5.
Heil M, Eitenmuller I, Schmitz-Rixen T, Schaper W. Arteriogenesis versus angiogenesis: similarities and differences. J Cell Mol Med. 2006;10:45–55.
Nakamura M, Imai H, Konno K, Kubota C, Seki K, Puentes S, Faried A, Yokoo H, Hata H, Yoshimoto Y, Saito N. Experimental investigation of encephalomyosynangiosis using gyrencephalic brain of the miniature pig: histopathological evaluation of dynamic reconstruction of vessels for functional anastomosis. Laboratory investigation. J Neurosurg Pediatr. 2009;3:488–95.
Mukawa M, Nariai T, Inaji M, Tamada N, Maehara T, Matsushima Y, Ohno K, Negi M, Kobayashi D. First autopsy analysis of a neovascularized arterial network induced by indirect bypass surgery for moyamoya disease: case report. J Neurosurg. 2016;124:1211–4.
Nariai T, Matsushima Y, Imae S, Tanaka Y, Ishii K, Senda M, Ohno K. Severe haemodynamic stress in selected subtypes of patients with moyamoya disease: a positron emission tomography study. J Neurol Neurosurg Psychiatry. 2005;76:663–6.
Powers WJ. Cerebral hemodynamics in ischemic cerebrovascular disease. Ann Neurol. 1991;29:231–40.
Derdeyn CP, Videen TO, Yundt KD, Fritsch SM, Carpenter DA, Grubb RL, Powers WJ. Variability of cerebral blood volume and oxygen extraction: stages of cerebral haemodynamic impairment revisited. Brain: A Journal of Neurology. 2002;125:595–607.
Ishii Y, Nariai T, Tanaka Y, Mukawa M, Inaji M, Maehara T, Ohno K. Practical clinical use of dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) for the surgical treatment of Moyamoya disease. Neurosurgery. 2013;
Nariai T, Suzuki R, Matsushima Y, Ichimura K, Hirakawa K, Ishii K, Senda M. Surgically induced angiogenesis to compensate for hemodynamic cerebral ischemia. Stroke. 1994;25:1014–21.
Aoyagi M, Tanaka Y, Tamura K, Maehara T, Nariai T, Ohno K. Vascularized flap with multiple small dural opening for bypass surgery in moyamoya patients with occlusive lesioin in posterior circulation (in Japanese). Video J Japan Neurosurg. 2007:15.
Hara S, Tanaka Y, Ueda Y, Hayashi S, Inaji M, Ishiwata K, Ishii K, Maehara T, Nariai T. Noninvasive evaluation of CBF and perfusion delay of Moyamoya disease using arterial spin-labeling MRI with multiple Postlabeling delays: comparison with (15)O-gas PET and DSC-MRI. AJNR Am J Neuroradiol. 2017;38:696–702.
Adelson PD, Scott RM. Pial synangiosis for moyamoya syndrome in children. Pediatr Neurosurg. 1995;23:26–33.
Kim CY, Wang KC, Kim SK, Chung YN, Kim HS, Cho BK. Encephaloduroarteriosynangiosis with bifrontal encephalogaleo(periosteal)synangiosis in the pediatric moyamoya disease: the surgical technique and its outcomes. Child’s Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery. 2003;19:316–24.
Ishii Y, Tanaka Y, Momose T, Yamashina M, Sato A, Wakabayashi S, Maehara T, Nariai T. Chronologic evaluation of cerebral hemodynamics by dynamic susceptibility contrast magnetic resonance imaging after indirect bypass surgery for Moyamoya disease. World Neurosurg. 2017;108:427–35.
Hayashi T, Shirane R, Fujimura M, Tominaga T. Postoperative neurological deterioration in pediatric moyamoya disease: watershed shift and hyperperfusion. J Neurosurg Pediatr. 2010;6:73–81.
Fujimura M, Kaneta T, Mugikura S, Shimizu H, Tominaga T. Temporary neurologic deterioration due to cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with adult-onset moyamoya disease. Surg Neurol. 2007;67:273–82.
Ishii Y, Nariai T, Tanaka Y, Mukawa M, Inaji M, Maehara T, Ohno K. Practical clinical use of dynamic susceptibility contrast magnetic resonance imaging for the surgical treatment of moyamoya disease. Neurosurgery. 2014;74:302–9.
Hara S, Kudo T, Hayashi S, Inaji M, Tanaka Y, Maehara T, Ishii K, Nariai T. Improvement in cognitive decline after indirect bypass surgery in adult moyamoya disease: implication of (15)O-gas positron emission tomography. Ann Nucl Med. 2020;34:467–75.
Yanagihara W, Chida K, Kobayashi M, Kubo Y, Yoshida K, Terasaki K, Ogasawara K. Impact of cerebral blood flow changes due to arterial bypass surgery on cognitive function in adult patients with symptomatic ischemic moyamoya disease. J Neurosurg. 2018;131:1716–24.
Miyamoto S, Yoshimoto T, Hashimoto N, Okada Y, Tsuji I, Tominaga T, Nakagawara J, Takahashi JC, Investigators JAMT. Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan adult Moyamoya trial. Stroke. 2014;45:1415–21.
Kuroda S, and Amore Study Group. Asymptomatic moyamoya disease: literature review and ongoing AMORE study. Neurol Med Chir. 2015;55:194–8.
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Nariai, T. (2021). Indirect Bypass Surgery for Moyamoya Disease. In: Kuroda, S. (eds) Moyamoya Disease: Current Knowledge and Future Perspectives. Springer, Singapore. https://doi.org/10.1007/978-981-33-6404-2_24
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DOI: https://doi.org/10.1007/978-981-33-6404-2_24
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