New Chinese Neurosurgical Journal Study Report Novel Surgical Strategy for Moyamoya Disease

A tailored revascularization approach preserves artery function and supports long-term stroke prevention in patients with moyamoya disease

CHINA, May 11, 2026 /EINPresswire.com/ -- A new multicentre retrospective study reports a new cerebral revascularization strategy for treating moyamoya disease that prioritizes preservation of the superficial temporal artery and individualized bypass selection based on vessel size. Tested among 303 adult patients, the strategy achieved high bypass patency rates, improved brain perfusion, and low long-term recurrent stroke risk during extended follow-up. These results suggest a practical, adaptable surgical pathway for improving clinical outcomes for this progressive cerebrovascular disorder.

Moyamoya disease is a rare and progressive cerebrovascular disorder in which major arteries at the base of the brain gradually narrow, restricting blood flow and increasing the risk of stroke, brain hemorrhage, and cognitive decline. The condition, observed commonly in Asian populations, often affects adults during the most productive years of their lives. Although surgery to restore blood supply is considered the best treatment, neurosurgeons continue to refine techniques that can safely improve circulation while minimizing complications.

Now, a research team from China led by Professor Yongbo Yang from the Department of Neurosurgery at Nanjing University Medical School and Dr. Dong Zhang from the Department of Neurosurgery at Beijing Hospital evaluated a new concept called the superficial temporal artery patency concept (STAPC), which places preservation of the superficial temporal artery at the center of surgical planning. The results of their work were published in Volume 12, Issue 5 of the Chinese Neurosurgical Journal on February 26, 2026.

The superficial temporal artery is an important external vessel that can be redirected to nourish the brain when internal circulation has been compromised. “Instead of using a one-size-fits-all strategy, the STAPC method uses vessel diameter, blood-flow dynamics, and the condition of recipient brain arteries to guide decisions regarding whether to perform a direct bypass, an indirect bypass, or a combined procedure. The goal is to create durable collateral circulation while preserving long-term donor artery function,” explains Prof. Yang.

The researchers retrospectively reviewed outcomes in 303 adult patients treated at two Chinese medical centers between 2019 and 2021. Among them, 170 underwent combined superficial temporal artery-middle cerebral artery bypass with encephalo-duro-arterio-synangiosis while 133 received indirect bypass surgery alone. The team used computed tomography (CT) angiography to assess bypass patency, CT perfusion imaging to measure blood-flow recovery, and long-term clinical monitoring to detect recurrent stroke events.

The results were promising. More than 95% of bypasses remained open at both 3 and 12 months after surgery. Brain perfusion improved in nearly one-quarter of patients at 3 months and in over 40% at one year, with stronger gains in the combined bypass group. Across patients followed for a median of 50 months, recurrent stroke events occurred at an annual rate below 4%, suggesting sustained protection in a disease known for progressive vascular decline.

“Preserving the superficial temporal artery while matching the operation to each patient’s hemodynamic needs may help us improve both short-term recovery and long-term durability,” says Prof. Yang. “Our findings support a more individualized pathway for treating moyamoya disease.”

The study also highlights broader ripple effects for cerebrovascular surgery. Principles from STAPC—real-time flow assessment, vessel matching, and tailored reconstruction—may inform future approaches for complex stroke prevention, bypass refinement, and surgical planning technologies. Collaborations between neurosurgeons, imaging specialists, biomedical engineers, and data scientists could further improve patient selection and intraoperative decision-making.

In the short term, patients can benefit from safer operations, better blood-flow restoration, and fewer repeat strokes. Over the next 5 to 10 years, more personalized revascularization strategies could reduce disability, preserve independence, and lower long-term healthcare costs associated with stroke rehabilitation and chronic neurological care. Moreover, earlier interventions can also help working-age adults maintain a healthy quality of life.

Dr. Zhang adds, “For many clinicians, the challenge is not whether to revascularize but how to choose the right operation for the right patient. Our concept provides a practical framework that can continue to evolve with better imaging and multicenter evidence.”

While the team notes that future prospective randomized studies are still needed, the current findings suggest that STAPC represents an important next step in individualized brain revascularization for patients with moyamoya disease.

Reference
Title of original paper: A novel superficial temporal artery patency concept of cerebral revascularization for patients with moyamoya disease: A multicenter study

Journal: Chinese Neurosurgical Journal
DOI: https://doi.org/10.1186/s41016-025-00424-4


About the Chinese Neurosurgical Journal
The Chinese Neurosurgical Journal is an international, peer-reviewed, open-access journal dedicated to advancing clinical practice and research across all areas of neurosurgery. As the official journal of the Chinese Neurosurgical Society, it publishes cutting-edge studies on neurosurgical techniques, neuro-oncology, cerebrovascular disease, trauma, spinal disorders, and emerging neuroscience trends. The journal emphasizes clinically relevant innovations that improve patient outcomes, surgical decision-making, and multidisciplinary care worldwide. Indexed in major databases including PubMed Central, Scopus, and DOAJ, it ensures high visibility and accessibility for global researchers and clinicians while promoting collaboration, education, and knowledge exchange across disciplines in neurological science. Website: https://cnjournal.biomedcentral.com/

About Professor Yongbo Yang
Yongbo Yang is currently working as a Professor in the Department of Neurosurgery at Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, People’s Republic of China. He is recognized as an advanced expert in moyamoya disease and is based in Nanjing, China, where he is actively involved in clinical practice and academic neurosurgery. He is highly rated in these conditions, according to available data. His major areas of expertise include moyamoya disease, brain aneurysm, stroke, cerebral artery bypass surgery, and extracranial–intracranial bypass surgery. His research portfolio includes co-authoring 32 peer-reviewed articles in leading neurosurgery and cerebrovascular medicine journals.

About Dr. Dong Zhang
Dr. Dong Zhang is affiliated with the Department of Neurosurgery at Beijing Hospital, Dongcheng District, Beijing, China. His work focuses on cerebrovascular neurosurgery, stroke prevention, and advancing surgical strategies for patients with moyamoya disease and related vascular disorders.

Funding information
This study was supported by grants from the National Natural Science Foundation of China (Grant No.: 82201481).

Yi Lu
Chinese Neurosurgical Journal
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