Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study

Background: Moyamoya disease (MMD) is characterized by the development of collateral circulation through the dura mater and overexpression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFBGF). Type 1 collagen promotes VEGF- and bFBGF-dependent neovascularization. T...

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Main Authors: Izumi Yamaguchi, Yasuhisa Kanematsu, Kenji Shimada, Masaaki Korai, Takeshi Miyamoto, Shu Sogabe, Manabu Ishihara, Tatsuya Haboshi, Yasushi Takagi
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:World Neurosurgery: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590139725000572
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author Izumi Yamaguchi
Yasuhisa Kanematsu
Kenji Shimada
Masaaki Korai
Takeshi Miyamoto
Shu Sogabe
Manabu Ishihara
Tatsuya Haboshi
Yasushi Takagi
author_facet Izumi Yamaguchi
Yasuhisa Kanematsu
Kenji Shimada
Masaaki Korai
Takeshi Miyamoto
Shu Sogabe
Manabu Ishihara
Tatsuya Haboshi
Yasushi Takagi
author_sort Izumi Yamaguchi
collection DOAJ
description Background: Moyamoya disease (MMD) is characterized by the development of collateral circulation through the dura mater and overexpression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFBGF). Type 1 collagen promotes VEGF- and bFBGF-dependent neovascularization. The usefulness of collagen matrix duraplasty has not been investigated in MMD, particularly regarding vascularization. The present retrospective study aimed to assess whether collagen matrix duraplasty enhances the postoperative vascularization in adult-onset MMD. Methods: Twenty-six patients (40 bypasses) who underwent direct bypass surgery for adult-onset MMD were included. The patients were categorized into a collagen matrix group (CMG; n = 17 [25 bypasses]) and a control group (CG; n = 9 [15 bypasses]). We compared postoperative vascularization with cerebral angiography, single-photon emission computed tomography (SPECT), and stroke-free survival. Results: The direct bypass was patent in 92 % of CMG and 86.7 % of CG, with no significant difference (p = 0.623). Middle meningeal artery blush was observed in 76 % of CMG and 80 % of CG, indicating similar development (p > 0.99). Matsushima angiographic grade was comparable between groups (good: CMG 20 %, CG 6.7 %; fair: CMG 72 %, CG 80 %; poor: CMG 8 %, CG 13.3 %), with no significant differences. The median relative cerebral blood flow significantly increased postoperatively in CMG (preoperative 0.85, postoperative 0.94; p = 0.009) but not in CG (preoperative 0.93, postoperative 0.94; p = 0.455). The two-year stroke-free survival based on duraplasty showed no significant difference (p = 0.726) between groups. Conclusions: Collagen matrix duraplasty does not enhance the postoperative vascularization status after direct bypass surgery in adult-onset MMD in the short term.
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spelling doaj-art-990a52eccc6f4a90acf3bf4a76eecad72025-08-20T02:38:51ZengElsevierWorld Neurosurgery: X2590-13972025-07-012710048310.1016/j.wnsx.2025.100483Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort studyIzumi Yamaguchi0Yasuhisa Kanematsu1Kenji Shimada2Masaaki Korai3Takeshi Miyamoto4Shu Sogabe5Manabu Ishihara6Tatsuya Haboshi7Yasushi Takagi8Corresponding author. Department of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan.; Department of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neurosurgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanBackground: Moyamoya disease (MMD) is characterized by the development of collateral circulation through the dura mater and overexpression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFBGF). Type 1 collagen promotes VEGF- and bFBGF-dependent neovascularization. The usefulness of collagen matrix duraplasty has not been investigated in MMD, particularly regarding vascularization. The present retrospective study aimed to assess whether collagen matrix duraplasty enhances the postoperative vascularization in adult-onset MMD. Methods: Twenty-six patients (40 bypasses) who underwent direct bypass surgery for adult-onset MMD were included. The patients were categorized into a collagen matrix group (CMG; n = 17 [25 bypasses]) and a control group (CG; n = 9 [15 bypasses]). We compared postoperative vascularization with cerebral angiography, single-photon emission computed tomography (SPECT), and stroke-free survival. Results: The direct bypass was patent in 92 % of CMG and 86.7 % of CG, with no significant difference (p = 0.623). Middle meningeal artery blush was observed in 76 % of CMG and 80 % of CG, indicating similar development (p > 0.99). Matsushima angiographic grade was comparable between groups (good: CMG 20 %, CG 6.7 %; fair: CMG 72 %, CG 80 %; poor: CMG 8 %, CG 13.3 %), with no significant differences. The median relative cerebral blood flow significantly increased postoperatively in CMG (preoperative 0.85, postoperative 0.94; p = 0.009) but not in CG (preoperative 0.93, postoperative 0.94; p = 0.455). The two-year stroke-free survival based on duraplasty showed no significant difference (p = 0.726) between groups. Conclusions: Collagen matrix duraplasty does not enhance the postoperative vascularization status after direct bypass surgery in adult-onset MMD in the short term.http://www.sciencedirect.com/science/article/pii/S2590139725000572Moyamoya diseaseDuragenCollagen matrix graftDirect bypassAngiogenesisNeovascularization
spellingShingle Izumi Yamaguchi
Yasuhisa Kanematsu
Kenji Shimada
Masaaki Korai
Takeshi Miyamoto
Shu Sogabe
Manabu Ishihara
Tatsuya Haboshi
Yasushi Takagi
Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study
World Neurosurgery: X
Moyamoya disease
Duragen
Collagen matrix graft
Direct bypass
Angiogenesis
Neovascularization
title Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study
title_full Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study
title_fullStr Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study
title_full_unstemmed Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study
title_short Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study
title_sort comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in moyamoya disease a single institute retrospective cohort study
topic Moyamoya disease
Duragen
Collagen matrix graft
Direct bypass
Angiogenesis
Neovascularization
url http://www.sciencedirect.com/science/article/pii/S2590139725000572
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