How I do it – extracranial-intracranial bypass surgery integrating STA-MCA anastomosis, synangiosis, MMA supply, and preservation of recipient artery perforators: the Integrated Method

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2025-10-04 DOI:10.1007/s00701-025-06689-z

Milad Neyazi, Rajiv Kumar Khajuria, Katharina Faust, Sajjad Muhammad

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引用次数: 0

Abstract

Background

Extracranial-intracranial (EC-IC) bypass is an effective revascularization technique for flow augmentation in conditions like Moyamoya disease and ischemic cerebrovascular disorders. The approach described here combines direct bypass (STA-MCA anastomosis), indirect bypass (encephaloduromyosynangiosis, EDMS), preservation of the middle meningeal artery (MMA), and preservation of recipient artery perforators to optimize outcomes.

Method

This article outlines a comprehensive surgical strategy emphasizing anatomical considerations, procedural nuances, and the integration of direct and indirect techniques while preserving MMA and recipient artery perforators to augment collateral circulation.

Conclusion

The Integrated Method described here encompasses four technical aspects so as to enhance revascularization, minimize complications, and improve long-term outcome in carefully selected patients.

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我是怎么做的——结合STA-MCA吻合、融合、MMA供应和保存受体动脉穿支的颅外-颅内搭桥手术：综合方法

背景颅-颅内（EC-IC）旁路是一种有效的血管重建技术，用于烟雾病和缺血性脑血管疾病等疾病的血流增加。本文描述的方法结合了直接旁路（STA-MCA吻合）、间接旁路（脑膜硬肌吻合症，EDMS）、保留脑膜中动脉（MMA）和保留受体动脉穿支来优化结果。方法本文概述了一种全面的手术策略，强调解剖学上的考虑，程序上的细微差别，以及直接和间接技术的结合，同时保留MMA和受体动脉穿支来增强侧支循环。结论在精心挑选的患者中，综合方法包括四个技术方面，以加强血运重建，减少并发症，改善长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.