Combined Revascularization
Contents
In brief: Combined revascularization pairs immediate flow from a direct bypass with the potential for broader delayed collateral growth from an indirect technique.
Use in moyamoya disease
Section titled “Use in moyamoya disease”A common construct is STA–MCA bypass plus EDAS or another synangiosis. The direct component may support an urgent territory while indirect components mature over months.
European expert consensus favors direct or combined strategies over indirect-only surgery for many adults with ischemic presentation. [1] Combined surgery also adds operative complexity and does not guarantee that every indirect territory will develop robust collaterals. [2]
Clinical detail
Section titled “Clinical detail”“Combined” covers many different operations. Reports should specify the direct anastomoses, indirect tissues, target territories, and postoperative flow assessment.