Characteristics of donor vessels and cerebral blood flow in the chronic phase after combined revascularization surgery for moyamoya disease

Abstract

Abstract This study aimed to determine whether donor vessel development after combined revascularization surgery for moyamoya disease (MMD) was related to cerebral blood flow (CBF) changes. We retrospectively reviewed the charts of 11 adults (12 hemispheres) and 13 children (19 hemispheres) who underwent combined revascularization in our department. The total vessel cross-sectional area (TVA) was the sum of the cross-sectional areas of the superficial temporal, middle meningeal, and deep temporal arteries imaged using time-of-flight magnetic resonance angiography. The ipsilateral relative CBF (RCBF) on the brain surface in the craniotomy area was calculated using single-photon emission computed tomography. The preoperative and postoperative ratios of the TVA and RCBF were defined as ΔTVA and ΔRCBF, respectively. Finally, we investigated the correlation between ΔTVA and ΔRCBF in adults and children. TVA and RCBF increased significantly after surgery regardless of the age group. The adult group had significantly higher ΔRCBF values than did the pediatric group (p < 0.01, r = −0.44). However, ΔTVA was not significantly correlated with ΔRCBF in either group. Thus, the increase in CBF was not correlated with changes in the measurable total donor vessel area. The findings suggest that postoperative development of major bypass vessels does not necessarily result in increased CBF.