Characteristics of donor vessels and cerebral blood flow in the chronic phase after combined revascularization surgery for moyamoya disease

This study aimed to analyze whether the development of donor vessels after combined revascularization surgery for moyamoya disease (MMD) was related to cerebral blood flow (CBF) changes. We retrospectively reviewed the charts of 11 adult (12 hemispheres) and 13 pediatric (19 hemispheres) patients who underwent combined revascularization in our department. The total vessel cross-sectional area (TVA) was the sum of the cross-sectional areas of the superficial temporal, middle meningeal, and deep temporal arteries imaged using time-of-flight magnetic resonance angiography. The ipsilateral relative CBF (RCBF) on the brain surface in the craniotomy area was calculated by single-photon emission computed tomography. The preoperative and postoperative ratios of the TVA and RCBF were defined as ΔTVA and ΔRCBF, respectively. Finally, we investigated the correlation between ΔTVA and ΔRCBF in adults and children. The TVA and RCBF showed a significant increase after surgery regardless of the age group. However, there was no significant correlation between ΔTVA and ΔRCBF in either the adult or pediatric groups. The adult group had significantly higher ΔRCBF values than the pediatric group (p