A novel superficial temporal artery patency concept of cerebral revascularization for patients with moyamoya disease: a multicenter study.

IF 1.7 Q2 Medicine

Chinese Neurosurgical Journal Pub Date : 2026-02-26 DOI:10.1186/s41016-025-00424-4

Zhiyong Shi, Xin Li, Xinhua Chen, Lingyun Wu, Rong Wang, Chunhua Hang, Yongbo Yang, Dong Zhang

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Abstract

Background: To summarize the clinical and radiological outcomes of a novel cerebral revascularization technique based on the superficial temporal artery patency concept (STAPC) in patients with moyamoya disease (MMD).

Methods: A retrospective review was conducted of adult patients with MMD treated at Beijing Hospital and Nanjing Drum Tower Hospital between January 2019 and December 2021. The cohort comprised 170 patients who underwent superficial temporal artery-middle cerebral artery bypass with encephalo-duro-arterio-synangiosis (EDAS) (STA-MCA/EDAS), and 133 who underwent EDAS alone. Radiological follow-up included computed tomography (CT) angiography (CTA) to assess bypass patency and CT perfusion (CTP) for hemodynamic staging at 3 and 12 months post-revascularization. Clinical follow-up recorded perioperative complications and recurrent stroke events that occurred > 12 months postoperativerly.

Results: Of the 303 patients, 37 cases (12.21%) had perioperative complications including 27 cases (15.9%) in the STA-MCA/EDAS group and 10 cases (7.5%) in the EDAS group. Perfusion improvement was observed in 23.76% of patients (25.7% in the STA-MCA/EDAS group and 17.8% in the EDAS group) at 3 months postsurgical, and in 40.17% of patients (48.68% in the STA-MCA/EDAS group and 24.39% in the EDAS group) at 12 months postsurgical. Bypass patency was observed in 95.29% of patients (96.1% in the STA-MCA/EDAS group and 93.5% in the EDAS group) at 3 months postoperative, and in 96.43% patients (95.2% in the STA-MCA/EDAS group and 97.1% in the EDAS group) at 12 months postoperative. Of the 249 patients with a median follow-up period of 50 months (range 12-70 months), 40 cases (16.06%, 3.85% per year) had recurrent stroke events including 22 (15.41%, 3.69% per year) in the STA-MCA/EDAS group and 18 (16.67%, 3.91% per year) in the EDAS group.

Conclusions: Cerebral revascularization using STAPC is an acceptable surgical strategy for preventing stroke recurrence in patients with MMD.

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烟雾病患者脑血运重建的颞浅动脉开放新概念：一项多中心研究。

背景：总结一种基于颞浅动脉通畅概念（STAPC）的新型脑血运重建术治疗烟雾病（MMD）的临床和影像学结果。方法：回顾性分析2019年1月至2021年12月在北京医院和南京鼓楼医院治疗的成年烟雾病患者。该队列包括170例接受颞浅动脉-大脑中动脉搭桥合并脑硬动脉合并血管病（EDAS）（STA-MCA/EDAS）的患者，以及133例单独接受EDAS的患者。放射学随访包括计算机断层扫描（CT）血管造影（CTA）评估旁路通畅和CT灌注（CTP）血流动力学分期在血运重建术后3和12个月。临床随访记录围手术期并发症及术后12个月卒中复发情况。结果：303例患者中出现围手术期并发症37例（12.21%），其中STA-MCA/EDAS组27例（15.9%），EDAS组10例（7.5%）。术后3个月，23.76%的患者（STA-MCA/EDAS组25.7%，EDAS组17.8%）的灌注改善；术后12个月，40.17%的患者（STA-MCA/EDAS组48.68%，EDAS组24.39%）的灌注改善。术后3个月95.29%的患者（STA-MCA/EDAS组96.1%，EDAS组93.5%）旁路通畅，术后12个月96.43%的患者（STA-MCA/EDAS组95.2%，EDAS组97.1%）旁路通畅。249例患者中位随访期为50个月（12-70个月），40例（16.06%，每年3.85%）发生卒中复发事件，其中STA-MCA/EDAS组22例（15.41%，每年3.69%），EDAS组18例（16.67%，每年3.91%）。结论：STAPC脑血运重建术是预防烟雾病患者卒中复发的一种可接受的手术策略。

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