Direct Revascularization
Contents
In brief: Direct revascularization creates an immediate microsurgical connection between an artery outside the skull and a recipient artery on the brain surface.
Use in moyamoya disease
Section titled “Use in moyamoya disease”The common example is an STA–MCA bypass. It can improve flow promptly, which is an advantage when hemodynamic need is significant. Suitable donor and recipient vessels, microsurgical expertise, and careful flow selection are required.
European expert consensus generally favors direct or combined strategies over indirect-only surgery for many adults with ischemic presentation. [1] Risks include perioperative ischemia, hemorrhage, graft occlusion, hyperperfusion, and wound complications. [2]
Clinical detail
Section titled “Clinical detail”Bypass flow is not inherently “more is better.” The selected recipient territory and flow magnitude should match the regional hemodynamic problem.