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<p>Moyamoya disease (MMD) is a chronic progressive cerebrovascular disorder characterized by progressive stenosis or occlusion of specific intracranial arteries and formation of abnormal collateral vascular networks. Encephaloduroarteriosynangiosis (EDAS) has been widely applied across all age groups of MMD patients as a representative indirect revascularization technique. Although the underlying biological mechanisms and determinants of heterogeneous outcomes remain incompletely understood, emerging evidence suggests that, beyond angiogenesis induction, inflammatory microenvironment modulation, genetic susceptibility, and functional remodeling of the brain extracellular space (ECS) may collectively contribute to the therapeutic effects of EDAS. Imaging technology plays an irreplaceable role throughout the perioperative period: assisting preoperative diagnosis and surgical planning, improving intraoperative safety, and enabling postoperative evaluation of revascularization efficacy, complication surveillance, and functional recovery. This review synthesizes representative clinical evidence, summarizes current mechanistic insights, and highlights recent advances in imaging evaluation of EDAS, with particular emphasis on ECS remodeling as an emerging therapeutic and imaging target in MMD.</p>

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Mechanisms and Imaging Advances of Encephaloduroarteriosynangiosis in the Treatment of Moyamoya Disease

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Yanni Zhang,
  • Chao Lu,
  • Shuying Niu,
  • Mingming Zhao,
  • Feng Yin,
  • Jingge Lian

摘要

Moyamoya disease (MMD) is a chronic progressive cerebrovascular disorder characterized by progressive stenosis or occlusion of specific intracranial arteries and formation of abnormal collateral vascular networks. Encephaloduroarteriosynangiosis (EDAS) has been widely applied across all age groups of MMD patients as a representative indirect revascularization technique. Although the underlying biological mechanisms and determinants of heterogeneous outcomes remain incompletely understood, emerging evidence suggests that, beyond angiogenesis induction, inflammatory microenvironment modulation, genetic susceptibility, and functional remodeling of the brain extracellular space (ECS) may collectively contribute to the therapeutic effects of EDAS. Imaging technology plays an irreplaceable role throughout the perioperative period: assisting preoperative diagnosis and surgical planning, improving intraoperative safety, and enabling postoperative evaluation of revascularization efficacy, complication surveillance, and functional recovery. This review synthesizes representative clinical evidence, summarizes current mechanistic insights, and highlights recent advances in imaging evaluation of EDAS, with particular emphasis on ECS remodeling as an emerging therapeutic and imaging target in MMD.