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Intradural arteriosynagiosis in pediatric moyamoya disease: modified technique of encephalo–duro–arterio-synangiosis with reduced operative damage to already growing revascularization

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Abstract

Objective

Various operative procedures have been described for the treatment of pediatric moyamoya disease. However, the majority of invasive or radical procedures proposed have focused primarily on revascularization and few have discussed to maximizing preservation of the already growing neovascular network.

Methods

This present procedure describes the supratemporal artery is anastomosed to the inner layer of the dura mater and surrounded by the outer layer as a sandwich with a blunt procedure of dural layer separation.

Results

This technique efficiently established an anastomotic connection between the supratemporal artery and the cortical brain, and the dura mater postoperatively with maximally preserving the existing vascular network.

Conclusion

IDAS, the modified surgical technique of EDAS, shall be benefit in preserving the already developed colateral circulation, and underlying structure over the brain cortex as much as possible, which is important particularly in pediatric moyamoya patients.

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Disclosure

The authors have no financial interest in the described systems.

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Authors and Affiliations

  1. Department of Neurosurgery, Keio University, School of Medicine, Tokyo, Japan

    Jun Muto

  2. Division of Pediatric Neurosurgery, The Jikei University School of Medicine, Women’s and Children’s Medical Center, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan

    Jun Muto & Shizuo Oi

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  1. Jun Muto
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  2. Shizuo Oi
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Correspondence to Shizuo Oi.

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Muto, J., Oi, S. Intradural arteriosynagiosis in pediatric moyamoya disease: modified technique of encephalo–duro–arterio-synangiosis with reduced operative damage to already growing revascularization. Childs Nerv Syst 25, 607–612 (2009). https://doi.org/10.1007/s00381-009-0850-6

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  • DOI: https://doi.org/10.1007/s00381-009-0850-6

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