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Modified encephalo-duro-periosteal-synangiosis (EDPS) for the revascularization of anterior cerebral artery territory in moyamoya disease: A single-center experience

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机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Road, Beijing, 100070, China
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关键词: Moyamoya disease Indirect revascularization Pericranium Periosteum Encephalo-duro-periosteal-synangiosis EDPS ACA territory

摘要:
Objectives: Anterior cerebral artery (ACA) territory, a crucial area of intellectual development in children, is frequently involved in the progress of moyamoya disease (MMD). However, revascularization surgeries for this area are not as established as surgeries for middle cerebral artery (MCA) territory. This study aimed to describe our experience and study the effect of revascularizing ACA territory with periocranium and dural leaflets, which is referred to as `encephalo-duro-periosteal-synangiosis (EDPS)'. Patients and method: Fourteen hemispheres of 9 MMD patients who had undergone EDPS from November 2015 till July 2017 in our hospital were retrospectively included. Clinical characteristics and procedure-related information were recorded. Cerebral perfusion was evaluated by computed tomography perfusion (CTP). Absolute and relative (r) CTP parameters of ROIs in ACA territory at the level of centrum semiovale and middle basal ganglia were calculated. Preoperative and postoperative parameters were compared. Results: All EDPS procedures were technically successful with no postoperative complications. The mean operating time was 75.00 +/- 22.53 min per hemisphere. Postoperative absolute cerebral blood flow (CBF), rCBF were significantly increased and absolute time to peak (TTP), rTTP, absolute mean transit time (MTT) were significantly reduced in ACA territory at centrum semiovale level (P = 0.002, 0.045, 0.007, 0.005 and 0.039 respectively). Improved outcomes were achieved in five patients, stabilization in three and one patient had deterioration out of intracerebral hemorrhage during follow-up. Conclusion: EDPS is a simple but effective technique to revascularize ACA territory for MMD. EDPS significantly improved cerebral blood perfusion of frontal lobe in the majority of patients without increasing procedure-related risks.

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出版当年[2018]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2017]版:
Q3 SURGERY Q4 CLINICAL NEUROLOGY
最新[2023]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Road, Beijing, 100070, China
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通讯机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Road, Beijing, 100070, China
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