Quantitative Angiographic Comparison with OSIRIS Program Between the Direct and Indi

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BACKGROUND: Up to date, quantitative angiographic measurement of revascularization extent after bypass surgery has not been reported.

OBJECTIVE: To quantitatively measure the extent of angiographic revascularization six months postoperatively using the OSIRIS program (University Hospital of Geneva, version 3.1).

METHODS: A total of 75 bypass procedures were performed in 65 consecutive adult moyamoya disease (MMD) patients, and 71 bypass surgeries in 61 adult MMD patients were studied six months postoperatively using angiography. We performed five different types of bypass surgeries: encephaloduroarteriosynangiosis (EDAS); superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis (SMA); SMA with encephalomyosynangiosis (EMS); SMA with EDAS; and SMA with encephaloduroarteriomyosynangiosis (EDAMS). We also investigated single photon emission computed tomography (SPECT) results after six months postoperatively and compared the angiographic revascularization extent with the SPECT results.

RESULTS: The mean values for the extent of revascularization among five different bypass surgeries were: 32.4% in EDAS only; 57.4% in SMA only; 58.4% in SMA with EMS; 66.1% in SMA with EDAS; and 70.8% in SMA with EDAMS. There was a statistically significant difference in the extent of revascularization among the five surgical modalities (p-value=0.000) and between the EDAS only group and various SMA groups (p-value=0.000). Statistical analysis between angiographic revascularization extent and SPECT results demonstrated significant statistical correlation (p-value=0.000).

CONCLUSION: The extent of angiographic revascularization in adult MMD patients was highest in the SMA with EDAMS group and lowest in the EDAS only group. In addition, angiographic revascularization extent was well correlated with the change of SPECT.

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