Comparison of short-term effects of intracranial and extracranial vascular bypass grafting,brain-dura-artery-temporalis muscle patching application,and their combination in the treatment of adult moyamoya disease
LIU Shan-xian
WANG Lei
ZHANG Hong-yun
ZHENG Jie
XING Zhen-yi
Abstract：Objective To compare the short-term effects of intracranial and extracranial vascular bypass surgery,brain-dura-artery-temporalis muscle patching surgery,and their combination in the treatment of adult moyamoya dis-ease(MMD).Methods A total of 117 inpatients from the neurosurgery department were selected and divided into con-trol group,patching group,bypass group,and combined group according to inclusion criteria and surgical indications.The control group received routine treatment,the patching group underwent brain-dura-artery-temporalis muscle patching surgery,the bypass group underwent intracranial and extracranial vascular bypass surgery,and the combined group re-ceived both procedures.The improvement of cerebral blood flow dynamics(CBF,CBV,TTP,MTT)and cerebral oxygen metabolism indicators(SjvO2,Da-jvO2,CO2ER)were compared between pre-treatment and 1 week post-treatment,and patients were followed up for 3 months.The neurological function recovery was evaluated by comparing the NIHSS scores of each group at 3 months.Results In each surgical group,there was a statistically significant increase in CBF and CBV and a decrease in TTP and MTT before and after surgery(P＜0.05).The combined group showed better results than the patching group and bypass group,with statistically significant differences(CBF:t=7.870,6.725,P＜0.001;CBV:t=4.032,3.990,P＜0.001;TTP:t=2.701,2.688,P＜0.01;MTT:t=4.121,3.180,P＜0.01).There were statistically significant differences in SjvO2,Da-jvO2,and CO2ER before and after surgery in each surgical group(P＜0.05).The combined group showed better results than the patching group and bypass group,with statistically signif-icant differences(SjvO2:t=4.927,5.143,P＜0.01;Da-jvO2:t=3.421,3.139,P＜0.01;CO2ER:t=2.758,2.526,P＜0.01).The NIHSS scores at 3 months post-treatment showed statistically significant differences in each group before and after treatment(P＜0.05).The patching group and bypass group had statistically significant differences compared to the control group(t=3.027,2.998,P＜0.05),and the combined group had statistically significant differ-ences compared to the patching group and bypass group(t=3.182,3.866,P＜0.05).Conclusion Intracranial and extracranial vascular bypass surgery combined with brain-dura-artery-temporalis muscle patching surgery has a better short-term therapeutic effect in the treatment of adult cerebral arteriosclerotic occlusive disease.It can rapidly improve cerebral perfusion and oxygen metabolism and promote neurological function recovery to a certain extent.
Keywords：intracranial and extracranial vascular bypass graftingbrain-dura-artery-temporal muscle appli-cationmoyamoya disease
Publication Date：2023-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1385-1389 )