• Jae Seung Bang, O-Ki Kwon, Jeong Eun Kim, Hyun-Seung Kang, Hyun Park, Sung Yun Cho, and Chang Wan Oh.
• Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
• Neurosurgery. 2012 Mar 1;70(3):625-32; discussion 632-3.

BackgroundUp-to-date, quantitative angiographic measurement of revascularization extent after bypass surgery has not been reported.ObjectiveTo measure the extent of angiographic revascularization quantitatively 6 months postoperatively with the OSIRIS program (University Hospital of Geneva, version 3.1).MethodsA total of 75 bypass procedures were performed in 65 consecutive adult moyamoya disease patients, and 71 bypass surgeries in 61 adult moyamoya disease patients were studied 6 months postoperatively with angiography. We performed 5 different types of bypass surgeries: encephaloduroarteriosynangiosis (EDAS), superficial temporal artery-middle cerebral artery anastomosis (SMA), SMA with encephalomyosynangiosis (EMS), SMA with EDAS, and SMA with encephaloduroarteriomyosynangiosis (EDAMS). We also investigated single-photon emission computed tomography (SPECT) results after 6 months postoperatively and compared the angiographic revascularization extent with the SPECT results.ResultsThe mean values for the extent of revascularization among 5 different bypass surgeries were as follows: 32.4% for EDAS only, 57.4% for SMA only, 58.4% for SMA with EMS, 66.1% for SMA with EDAS, and 70.8% for SMA with EDAMS. There was a statistically significant difference in the extent of revascularization among the 5 surgical modalities (P = .000) and between the EDAS-only group and various SMA groups (P = .000). Statistical analysis between angiographic revascularization extent and SPECT results demonstrated significant statistical correlation (P = .000).ConclusionThe extent of angiographic revascularization in adult moyamoya disease patients was highest in the SMA with EDAMS group and lowest in the EDAS-only group. In addition, angiographic revascularization extent was well correlated with the change in SPECT.

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