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Last revised by Dr Francis Deng on 06 May 2022

Encephaloduroarteriosynangiosis (EDAS) is the most commonly used indirect revascularization surgery for moyamoya disease or syndrome, which provides a way to bypass an occluded internal carotid artery and circle of Willis without having to perform a direct surgical anastomosis. 

It involves dissection of superficial temporal artery branches with surrounding galea, creating a craniotomy and durotomy, and then suturing the galeal cuff to the durotomy edges so that the artery lies on the pial surface of the brain. Revascularization occurs as a result of angiogenesis driven by local hypoperfusion and ischemia 1,2. The deep temporal artery is the main arterial supply.

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