もやもや病に対する間接バイパス術の歴史と現状

History and Current Situation of Indirect Bypass Surgery for Moyamoya Disease

Point

・間接バイパス術の歴史は，血流の供給源の開発とより広範囲に効率的に血流を供給する方法の開発である．

・間接バイパス術による血管新生のメカニズムについては，未だ詳細は不明である．

・間接バイパス術の治療成績は良好であるが，成人虚血型もやもや病に対する適応や，出血型もやもや病に対する効果の検証が課題である．

　In indirect bypass surgery for moyamoya disease（MMD） angiogenesis is induced by attaching extracranial tissues to the brain surface, and the external carotid artery system supplements hemodynamic insufficiency in the internal carotid artery system. This procedure is specific to patients with MMD. The history of this procedure includes the development of blood supply sources and ways to efficiently supply blood to various areas of the brain. The mechanism underlying the angiogenesis induced by this procedure remains unclear. Evaluation of the indications for this procedure in adult patients with ischemic MMD and elucidation of its preventive effect on hemorrhagic MMD are warranted.