Various surgical techniques for direct or indirect vasoreconstruction have been developed for moyamoya disease [1-6]. The induction of neovascularization can be achieved in most patients by indirect surgery on the brain surface through vascularized tissues such as the galea, the dura mater, and the temporal muscle [7, 8], although the development of neovascularization after indirect surgery is slower than that induced by direct bypass and not sufficient in some patients. The results of direct bypass are not always excellent in terms of the extent of blood supply and the long-term patency . Adjunctive therapies to enhance neovascularization after indirect surgery may improve the angiographic and clinical results of patients with moyamoya disease.
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