Study On Treatment Effect Of Combined Application Of Direct And Indirect Cerebral Revascularization Surgery On Moyamoya Disease

Objective:By analyzing and comparing the clinical data of patients who have undergone surgerical cerebral revascularization for moyamoya disease,this paper summarizes the advantages and disadvantages of different surgical methods of revascularization,and discusses the effectiveness and safety of surgical treatment.Materials and Methods:Clinical data of 26 patients with moyamoya disease treated by the neurosurgery of China-Japan Union Hospital from March 2017 to December 2019 were selected.Clinical manifestations,signs,imaging(MRA,CTA,DSA,doppler ultrasound),surgery(direct,indirect,combined revascularization),complications,clinical prognosis and follow-up were summarized and analyzed.The efficacy and safety of surgical treatment of moyamoya disease were evaluated by comparing the improvement of preoperative and postoperative symptoms,grading evaluation of imaging changes,and score of modified Rankin scale.Result:Clinical data of 26 patients undergoing unilateral surgical treatment: according to the clinical prognosis evaluation criteria,88.4%(23/26 cases)had excellent or good clinical prognosis.Anastomotic patency accounted for 87.5%(21/24 cases)of the 24 cases after direct revascularization.According to the results of angiography,53.8%(14/26)of blood supply reconstruction were graded(matsushima grade).The score of the modified Rankin scale was improved in 20 cases(1 case with 0 points,10 cases with 1 point,7 cases with 2 points,6 cases with 3 points,2 cases with 4 points,9 cases with 0 points,8 cases with 1 point,6 cases with 2 points,2 cases with 3 points,1 case with 4 points).The comparison of postoperative and preoperative scores(P <0.05)was statistically significant,and the results showed that surgical treatment was effective in improving the prognosis.There were 7 cases of complications(3 cases of cerebral infarction,2 cases of epilepsy,and 2 cases of TIA),which were improved after symptomatic treatment,and no obvious neurological dysfunction was left compared with that before surgery.Conclusion:This study shows that Surgical Cerebral Revascularization is a safe and effective procedure for the treatment of moyamoya disease,and its long-term efficacy is particularly obvious,but long-term clinical studies with large samples are still needed to confirm.