Safety analysis of STA-MCA bypass combined with EDAS in the treatment of patients with moyamoya disease.

Abstract

This study evaluates the clinical efficacy and safety of superficial temporal artery to middle cerebral artery (STA-MCA) bypass combined with encephalo-duro-arterio-synangiosis (EDAS) in the treatment of moyamoya disease. A total of 80 patients with moyamoya disease who were treated at our institution between January 2022 and January 2024 were enrolled and randomly assigned to 2 groups: a control group (n = 40) and an observation group (n = 40). The control group underwent EDAS, while the observation group received STA-MCA bypass in addition to EDAS. Surgical success rates, cerebral blood flow (CBF) efficacy markers, neurological function scores, and surgical safety were comprehensively assessed in both groups. The surgical success rate in the observation group was 95.00%, significantly higher than 75.00% in the control group (P < .05). Three days postoperatively, the observation group exhibited significantly higher CBF and cerebral blood volume compared to the control group, with reduced time to peak and mean transit time (P < .05). One month after surgery, the observation group had significantly lower modified Rankin Scale and National Institutes of Health Stroke Scale scores, and higher mini-mental state examination scores compared to the control group (P < .05). The incidence of perioperative complications was 15.00% in the observation group and 17.50% in the control group, with no significant difference between the groups (P > .05). STA-MCA bypass combined with EDAS significantly improves surgical success rates, cerebral hemodynamic parameters, and neurological function outcomes in patients with moyamoya disease without increasing the incidence of surgical complications, indicating favorable safety.