SURGICAL TECHNIQUES AND THE RESULTS OF A FRONTO-TEMPORO-PARIETAL COMBINED INDIRECT BYPASS PROCEDURE FOR CHILDREN WITH MOYAMOYA-DISEASE - A COMPARISON WITH THE RESULTS OF ENCEPHALO-DURO-ARTERIO-SYNANGIOSIS ALONE

We recently treated children with Moyamoya disease using a fronto-temp oro-parietal combined indirect bypass procedure. Three different indir ect bypass procedures (frontal EMAS, EDAS, EMS) were simultaneously ca rried out at three different sites. We thus treated 16 sides in 12 ped iatric patients with Moyamoya disease using this method. Both the coll ateral formation and the improvement in the clinical symptoms were eva luated postoperatively. These results were then compared with those of the patients treated by EDAS alone. The postoperative collateral form ation was more extensively seen in the patients treated with the combi ned bypass procedure than in those treated by EDAS alone. The improvem ent in ischemic symptoms was also better in the patients treated by th e combined indirect bypass procedure. We therefore conclude that the c ombined indirect bypass procedure is more effective than EDAS alone. ( C) 1997 Elsevier Science B.V.