Indirect Revascularization
Contents
In brief: Indirect revascularization places blood-supplied tissue in contact with the brain, encouraging new vessels to grow into the cerebral circulation over time.
Use in moyamoya disease
Section titled “Use in moyamoya disease”Techniques use scalp artery, temporalis muscle, dura, periosteum, or multiple openings. Unlike direct bypass, benefit is delayed while angiogenesis occurs. Collateral growth can take months and varies among patients.
Indirect operations are widely used in children and may cover broad territories. Japanese guidance recognizes indirect and combined approaches as established strategies. [1] Adults may develop less consistent indirect collateralization, which is one reason direct or combined surgery is often considered when feasible. [2]
Clinical detail
Section titled “Clinical detail”Procedure names describe which vascularized tissues are used, but technical variations are common. Follow-up angiography evaluates the actual collateral result.