Direct Revascularization

Direct Revascularization

Direct revascularization (STA-MCA bypass) involves use of a branch of a scalp artery (STA) for direct anastomosis (connection) to a branch of the brain artery (MCA) on the outer surface of the brain. This procedure benefits patients by providing an immediate improvement in blood supply to the brain. It's also known as an extracranial to intracranial bypass graft (EC-IC bypass). By virtue of doing the STA-MCA bypass and laying the STA directly on the brain surface, an indirect revascularization is achieved as well. Through enlargement of the STA and increased indirect revascularization, blood flow is expected to continue improving over a period of several months.

In the series of patients who have had direct bypass grafts at The Moyamoya Center, results indicate a greater than 95 %graft patency with excellent long term outcomes. Patients are typically hospitalized for 3-5 days, with overall recovery taking between 2 - 6 weeks before returning to all pre-surgery activities. This procedure is our first line recommendation in patients who are eligible. Many children under 5 often don't have arteries large enough to bypass, and may not be candidates for this particular surgery.