Factors Influencing Collateral Circulation Formation After Indirect Revascularization for Moyamoya Disease: a Narrative Review

Indirect revascularization is one of the main techniques for the treatment of Moyamoya disease. The formation of good collateral circulation is a key measure to improve cerebral blood perfusion and reduce the risk of secondary stroke, and is the main method for evaluating the effect of indirect revascularization. Therefore, how to predict and promote the formation of collateral circulation before and after surgery is important for improving the success rate of indirect revascularization in Moyamoya disease. Previous studies have shown that vascular endothelial growth factor, endothelial progenitor cells, Caveolin-1, and other factors observed in patients with Moyamoya disease may play a key role in the generation of collateral vessels after indirect revascularization through endothelial hyperplasia and smooth muscle migration. In addition, mutations in the genetic factor RNF213 have also been associated with this process. This study summarizes the factors and mechanisms influencing collateral circulation formation after indirect revascularization in Moyamoya disease.

Automated summary

Indirect revascularization is a crucial technique for treating Moyamoya disease. The formation of collateral circulation is key in improving cerebral blood perfusion and reducing the risk of stroke, and serves as a major indicator of the success of indirect revascularization. Predicting and promoting collateral circulation formation before and after surgery is important for the success of indirect revascularization in Moyamoya disease. Factors such as vascular endothelial growth factor, endothelial progenitor cells, Caveolin-1, and the genetic factor RNF213 play significant roles in the formation of collateral vessels after indirect revascularization through endothelial hyperplasia and smooth muscle migration.