Moyamoya disease (MMD) is a progressive, idiopathic cerebrovascular occlusive disease. Various revascularization techniques including direct, indirect, and combined microvascular bypasses have been described. This article presents a modified revascularization technique for MMD utilizing a pedicled temporoparietal fascial flap (TPFF) for combined revascularization. This technique combines a large area of coverage for indirect revascularization with the benefits of a direct bypass. The pedicled TPFF also benefits from intact venous drainage to minimize the risk of flap swelling that could result in complications from mass effect.
Keywords: EC-IC = extracranial-to-intracranial; ICA = internal carotid artery; MCA = middle cerebral artery; MMD = moyamoya disease; STA = superficial temporal artery; STA-MCA bypass; STV = superficial temporal vein; TPF = temporoparietal fascia; TPFF = temporoparietal fascial flap; cerebral revascularization; combined bypass surgery; moyamoya disease; surgical technique; temporoparietal pedicled flap; vascular disorders.