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In patients with Moyamoya disease undergoing combined revascularization, long-term regression of direct bypasses is associated with increased middle meningeal artery collateral networks that maintain cerebral perfusion without increasing stroke rates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 20, 2026Operative Neurosurgery

The Influence of Dual Revascularization Techniques on Middle Meningeal Artery Collateral Networks in Moyamoya Angiopathy

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Authors

EDEhsan Dowlati AKAlex F. Kuffer JBJeffrey M. Breton

Discussion

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Overview

Retrospective review shows increased MMA collaterals in Moyamoya patients following combined revascularization, indicating long-term benefits.

Key Points

Investigate the influence of dual revascularization techniques on middle meningeal artery collateral networks in Moyamoya angiopathy.
Retrospective review of patients undergoing combined revascularization for Moyamoya disease at a single center.
Analysis of preoperative and postoperative cerebral angiograms for MMA collaterals and direct bypass patency.
Quantitative vessel analysis using magnetic resonance angiography to measure hemispheric blood flow.
30.6% of patients had MMA collaterals preoperatively, increasing to 63.9% post-revascularization (P < .01).
In the patent direct bypass group, 54.2% had MMA collaterals, while 91.7% in the regressed bypass group (P = .03).
Overall, postoperative blood flow did not significantly decrease (311 ± 150 mL/min to 275 ± 85 mL/min; P = .33).

Cite This Study

Dowlati et al. (2026) studied this question.

synapsesocial.com/papers/6a362f11db0793dc1a536a07 https://doi.org/10.1227/ons.0000000000002119

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June 20, 2026Operative Neurosurgery

The Influence of Dual Revascularization Techniques on Middle Meningeal Artery Collateral Networks in Moyamoya Angiopathy

View Full Paper

Ask AI

Bookmark

Authors

EDEhsan Dowlati AKAlex F. Kuffer JBJeffrey M. Breton

Discussion

Member takes

Overview

Retrospective review shows increased MMA collaterals in Moyamoya patients following combined revascularization, indicating long-term benefits.

Key Points

Investigate the influence of dual revascularization techniques on middle meningeal artery collateral networks in Moyamoya angiopathy.
Retrospective review of patients undergoing combined revascularization for Moyamoya disease at a single center.
Analysis of preoperative and postoperative cerebral angiograms for MMA collaterals and direct bypass patency.
Quantitative vessel analysis using magnetic resonance angiography to measure hemispheric blood flow.
30.6% of patients had MMA collaterals preoperatively, increasing to 63.9% post-revascularization (P < .01).
In the patent direct bypass group, 54.2% had MMA collaterals, while 91.7% in the regressed bypass group (P = .03).
Overall, postoperative blood flow did not significantly decrease (311 ± 150 mL/min to 275 ± 85 mL/min; P = .33).

Cite This Study

Dowlati et al. (2026) studied this question.

synapsesocial.com/papers/6a362f11db0793dc1a536a07 https://doi.org/10.1227/ons.0000000000002119

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