Presence of Collaterals from the Contralateral Hemisphere on Preoperative Angiogram Predicts Failure of Encephalo-Duro Arterio-Synangiosis (EDAS) in Adult Moyamoya Patients.

Higher Suzuki-stages, ACA and ICA occlusion predict successful neovascularization after EDAS. The presence of robust preoperative contralateral interhemispheric collaterals is an important predictor of poor collateral vessel ingrowth following EDAS. This finding suggests that such collateralization might reduce the local ischemic stimulus required for effective indirect revascularization. These findings could refine surgical decision-making by identifying patients who may be less likely to benefit from EDAS.