What is the difference between an operation like a pial synangiosis and the other operations that are recommended for moyamoya syndrome in children?
The pial synangiosis differs from the so-called”indirect” procedures like EDAS (encephaloduroarteriosynangiosis), EMS (encephalomyosynangiosis), omental transposition or transfer, dural inversion procedures, etc., in that the surgical technique of pial synangiosis uses a wide opening of all of the membranes covering the brain and the fixing of the donor tissue – the scalp artery – directly to the brain surface with tiny sutures to promote more rapid development of arterial ingrowth to nourish the brain. There are numerous technical considerations, advantages and disadvantages of each surgical technique used in this condition, and it is beyond the scope of this FAQ to review them in detail. You should discuss these issues with the surgeon you have consulted, particularly to determine why a particular technique is being recommended and what the surgical results have been with the recommended procedure. All of these procedures are called “indirect” because they induce new blood vessel gro
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