Encephaloduroarteriosynangiosis for moyamoya disease

EDAS, left

This is a video of EDAS (Encephalodurosynangiosis) surgery performed using indirect anastomosis for Moyamoya disease.

When performing skin incision, the depth should be just enough to expose the hair follicles to expose the superficial temporal artery (STA). The STA is dissected together with the Galea over the muscle fascia.

The muscle is incised parallel to the STA direction to expose the bone, and the bone flap is made as large as possible and separated carefully so as not to damage the middle meningeal artery (MMA).

Dural incision is made parallel to the STA run to minimize MMA injury, and arachnoid membrane tearing is performed only partially if necessary.

The peeled STA and Dura are sutured and applied tachoseally to prevent CSF leakage.

For bone flaps, an absorbable plate can be used for children under 8 years of age, and a titanium plate can be used thereafter.

The skin is closed layer by layer, and continuous sutures are performed with rapid vicryl. One hemovac is inserted.