もやもや病に対するバイパス術の長期予後

Long-term Outcome of Bypass Surgery for Moyamoya Disease

Point

・もやもや病における血行再建術の長期成績を，直接バイパス（direct bypass），間接バイパス（indirect bypass），複合バイパス（combined bypass）の3術式間で比較した．

・複合バイパスが最も低い脳卒中再発率を示し，長期的な機能予後も良好であることを示唆している．

・もやもや病の外科的治療に関して，適応判断や手術戦略について実践的な視点や，今後の課題や展望を提供する．

　Moyamoya disease（MMD） is a progressive cerebrovascular disorder characterized by the stenosis or occlusion of the terminal portion of the internal carotid artery and its major branches. Surgical revascularization is important in the management of patients with MMD. This report compared the long-term outcomes of direct, indirect, and combined bypass techniques focusing on stroke recurrence rates and functional prognosis. Recent meta-analyses and clinical reports suggest that combined bypass provide the best long-term outcomes, reducing the risk of stroke recurrence and improving hemodynamic stability. These findings are crucial for neurosurgeons in selecting the optimal surgical approach for adult patients with MMD.