The Clinical Effect Of Superficial Temporal Artery-middle Cerebral Artery Bypass In The Treatment Of Adult Moyamoya Disease

Objective: To investigate the clinical efficacy of temporal artery-middle cerebral artery bypass in the treatment of moyamoya disease in adults.Methods: A total of 30 patients(12 males and 18 females)who were diagnosed with moyamoya disease by digtal subtraction angiography in the hospital from November 2017 to June 2019.And these patients were assessed for unilateral superficial temporal artery-middle cerebral artery bypass surgery.The patients ranged in age from 18 to 60 years,with an average age of 43±6.2 years.Among them,there were 25 cases of ischemic type and 5 cases of hemorrhagic type.Head CT examination was performed on the first day after the operation to determine whether the operation caused acute hemorrhage or infarction.All patients underwent modified Rankin Scale(m RS)and CT Perfusion imaging(CTP)immediately after admission and 1 week after surgery,in which the modified Rankin Scale was used to evaluate the neurological function and the CT Perfusion imaging(CTP)was used to evaluate the degree of improvement in brain Perfusion.In addition,CT angiography(CTA)was used in this study to evaluate the patency and perfusion range of bridge vessels 1 week after surgery.Results:On the first day after the operation,CT examination of the brain indicated that no serious complications such as cerebral hemorrhage or cerebral infarction occurred in all the patients,and only one case presented subcutaneous hematoma.One week after the operation,the m RS score of all the patients was lower than that before the operation,and the difference was statistically significant(P<0.05).The postoperative improvement rate of CBF was 24.55±16.15%.One week after the operation,CTA examination indicated that bridge vessels were unobturbed in all patients,among which the perfusion range of superficial temporal artery ≥1/3 of the blood supply area of middle cerebral artery was 24 cases.Conclusion: Superficial temporal artery-middle cerebral artery bypass can effectively improve the cerebral perfusion and neurological function in adult patients with moyamoya disease,and the postoperative complications are less.