Hemodynamic study with duplex ultrasonography on combined (direct/indirect) revascularization in adult moyamoya disease.

To evaluate the hemodynamic changes by duplex ultrasonography in adult moyamoya disease (MMD) patients who underwent combined direct and indirect revascularization surgery.Seventeen adult patients underwent direct and indirect revascularization surgery in our hospital. Hemodynamic parameters, peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), were determined by color Doppler at the baseline, 2 weeks, and 6 months after bypass.Both the PSV and EDV of direct bypass were lower at 6 months after surgery compared with those at 2 weeks postoperatively. The EDV of indirect revascularization surgery of the maxillary artery (MA) at 6 months after surgery was higher and the RI of the MA lower compared with the baseline levels. Decreased PSV and EDV in the bypass vessel did not significantly correlate with increased EDV or decreased RI of the MA.Duplex ultrasonography is a reliable, noninvasive tool to assess hemodynamic changes and evaluate the therapeutic performance of combined bypass surgery in adult MMD.