Encephaloduroarteriosynangiosis for Pediatric Moyamoya disease

• Encephaloduroarteriosynangiosis for the Treatment of Cerebral Arteriovenous Malformations in the Pediatric Population
• The Association of Heterozygous p.R4810K of RNF213 and Long-Term Unfavorable Outcomes after Encephaloduroarteriosynangiosis in Chinese Pediatric Patients with Moyamoya Disease
• Clinical Course, Therapy, and Long-Term Outcomes of Children With Moyamoya Disease and Posterior Cerebral Artery Involvement
• Effects of goal-directed analgesia using the analgesia nociception index in children undergoing surgery for moyamoya disease: A randomised controlled trial
• Indirect revascularization for pediatric moyamoya disease
• Indirect Bypass With Pericranial Transposition for Moyamoya Syndrome in an Infant
• Revascularization Surgery for Moyamoya Vasculopathy: An Australian Experience
• Risk Factors for Preoperative Cerebral Infarction in Infants with Moyamoya Disease

EDAS/encephalomyoarteriosynangiosis (EMAS) provides a stroke-prevention benefit with an acceptably low morbidity rate. Given the combined experience with EDAS and EMAS for this indication at this and other institutions, a prospective clinical trial to assess their efficacy compared with that of chronic transfusion therapy alone is warranted ¹⁾.

Six children underwent 8 EDAS procedures and were followed from 6 months to 9 years after surgery. No patient experienced further deterioration in neurologic status. Postoperative angiography demonstrated cerebral revascularization from the donor scalp artery on 3 of the 6 EDASs that were studied. The 2 patients who did not revascularize after EDAS demonstrated angiographic regression of their disease. The data suggest that EDAS is a safe procedure for the treatment of childhood moyamoya disease. Given the potential severity of the sequelae, early operative intervention is recommended in all children with this disease ²⁾.