Abstract
Objective
Indirect bypass using autologous tissue is effective in Moyamoya disease, especially inpediatric patients. The aim of this study was to evaluate the effectiveness of indirect bypass using DuraGen, an absorbable artificial dura mater composed of collagen matrix, in place of autologous tissue in a rat model of chronic cerebral hypoperfusion.
Methods
Male Wistar rats were subjected to bilateral internal carotid artery occlusion and divided into three groups: control group without bypass surgery, group in which indirect bypass was performed using the temporalis muscle (encephalo-myo-synangiosis [EMS] group), and group in which DuraGen was used (Dura group). The ratio of the number of vascular endothelial cells, detected by antibodies to CD31 and glucose transporter type 1 (Glut-1), on the operative side to that on the non-operative side was measured and compared between the three groups.
Results
The ratio of CD31-positive cells was 1.50 ± 0.13 and 1.92 ± 0.29 in the EMS and Dura groups, and that of Glut-1-positive cells was 1.32 ± 0.1and 1.53 ± 0.18 in the EMS and Dura groups. No significant difference was observed in the ratio of vascular endothelial cells on the bypass side between the EMS and Dura groups.
Conclusion
Indirect bypass with DuraGen resulted in an increased ratio of vascular endothelial cells equivalent to that of indirect bypass with the temporalis muscle in a Rat model.This result indicated that in an actual indirect bypass for patients with MMD, the use of DuraGen may produce the same angiogenesis as using autologous tissue.