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Reply: REPLY: Considering the lack of a detailed description of the collateral circles in Moyamoya disease in the literature, the intention of our e were pleased to read the letter written by our colleagues group is to analyze in the future, after the analyses performed for Wfrom Wuhan about our recent article, “Angiographic collaterals between the ophthalmic artery and anterior cerebral Analysis of Natural Anastomoses between the Posterior and artery, the contribution of the other systems to reperfusion. Since Anterior Cerebral Arteries in Moyamoya Disease and Syndrome.” this pathology is very rare and often occurs in young patients and Their comments focused mainly on 2 issues analyzed in our article: with emergency presentation, the possibility to analize the differ- on the one hand, the importance of the posterior circulation in the ent collaterals involved into the riperfusion through selective development of collateral circles that allow compensation of the an- microcatheterization is limited. terior hypoperfused regions; on the other hand, the hemodynamic complexity of the cerebral circulation in patients with Moyamoya disease. The studies conducted byour 2groupsanalyzedthe com- REFERENCES pensatory, collateral circles present in Moyamoya disease from 2 1. Bonasia S, Ciccio G, Smajda S, et al. Angiographic analysis of natural anastomoses between the posterior and anterior cerebral arteries different points of view:Inour study, we focusedonanangio- in Moyamoya disease and syndrome. AJNR Am J Neuroradiol graphic description of the posterior cerebral artery–anterior cere- 2019;40:2066–72 CrossRef Medline bral artery (PCA-ACA) collaterals. The Wuhan group instead 2. Baltsavias G, Valavanis A, Filipce V, et al. Selective and superselective correlated some particular types of collaterals to the post–superficial angiography of pediatric moyamoya disease angioarchitecture: the temporal artery (STA)-MCA bypass hypoperfusion syndrome. The anterior circulation. Interv Neuroradiol 2014;20:403–12 CrossRef conclusions we both came to, even if from different points of view, Medline are the same: In patients with moreadvancedstagesofthe disease, 3. Baltsavias G, Khan N, Valavanis A. The collateral circulation in pedi- the contribution of PCA-ACA anastomoses becomes more and atric moyamoya disease. Child nervous system 2015;31:389–398 more consistent, though the posterior circulation is less affected by CrossRef Medline the disease. Although the posterior circle makes an important con- tribution in the reperfusion of ischemic areas, to have a more global picture, we must also consider the other collateral circles described 2,3 S. Bonasia by Baltsavias et al, in 2014 and 2015, the superficial meningeal Department of Neurosurgery systems (pio-pial and duro-pial connections) and the deep paren- Neurocenter of Southern Switzerland chymal systems (subependymal or periventricular and thalamic Regional Hospital of Lugano Lugano, Switzerland connections). T. Robert Department of Neurosurgery Neurocenter of Southern Switzerland Regional Hospital of Lugano http://dx.doi.org/10.3174/ajnr.A6503 University of the Southern Switzerland Lugano, Switzerland E42 Letters Jun 2020 www.ajnr.org http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

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Bonasia, S.; Robert, T.
American Journal of Neuroradiology , Volume 41 (6) – Jun 1, 2020
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Publisher
American Journal of Neuroradiology
Copyright
© 2020 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A6503
Publisher site
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Abstract

REPLY: Considering the lack of a detailed description of the collateral circles in Moyamoya disease in the literature, the intention of our e were pleased to read the letter written by our colleagues group is to analyze in the future, after the analyses performed for Wfrom Wuhan about our recent article, “Angiographic collaterals between the ophthalmic artery and anterior cerebral Analysis of Natural Anastomoses between the Posterior and artery, the contribution of the other systems to reperfusion. Since Anterior Cerebral Arteries in Moyamoya Disease and Syndrome.” this pathology is very rare and often occurs in young patients and Their comments focused mainly on 2 issues analyzed in our article: with emergency presentation, the possibility to analize the differ- on the one hand, the importance of the posterior circulation in the ent collaterals involved into the riperfusion through selective development of collateral circles that allow compensation of the an- microcatheterization is limited. terior hypoperfused regions; on the other hand, the hemodynamic complexity of the cerebral circulation in patients with Moyamoya disease. The studies conducted byour 2groupsanalyzedthe com- REFERENCES pensatory, collateral circles present in Moyamoya disease from 2 1. Bonasia S, Ciccio G, Smajda S, et al. Angiographic analysis of natural anastomoses between the posterior and anterior cerebral arteries different points of view:Inour study, we focusedonanangio- in Moyamoya disease and syndrome. AJNR Am J Neuroradiol graphic description of the posterior cerebral artery–anterior cere- 2019;40:2066–72 CrossRef Medline bral artery (PCA-ACA) collaterals. The Wuhan group instead 2. Baltsavias G, Valavanis A, Filipce V, et al. Selective and superselective correlated some particular types of collaterals to the post–superficial angiography of pediatric moyamoya disease angioarchitecture: the temporal artery (STA)-MCA bypass hypoperfusion syndrome. The anterior circulation. Interv Neuroradiol 2014;20:403–12 CrossRef conclusions we both came to, even if from different points of view, Medline are the same: In patients with moreadvancedstagesofthe disease, 3. Baltsavias G, Khan N, Valavanis A. The collateral circulation in pedi- the contribution of PCA-ACA anastomoses becomes more and atric moyamoya disease. Child nervous system 2015;31:389–398 more consistent, though the posterior circulation is less affected by CrossRef Medline the disease. Although the posterior circle makes an important con- tribution in the reperfusion of ischemic areas, to have a more global picture, we must also consider the other collateral circles described 2,3 S. Bonasia by Baltsavias et al, in 2014 and 2015, the superficial meningeal Department of Neurosurgery systems (pio-pial and duro-pial connections) and the deep paren- Neurocenter of Southern Switzerland chymal systems (subependymal or periventricular and thalamic Regional Hospital of Lugano Lugano, Switzerland connections). T. Robert Department of Neurosurgery Neurocenter of Southern Switzerland Regional Hospital of Lugano http://dx.doi.org/10.3174/ajnr.A6503 University of the Southern Switzerland Lugano, Switzerland E42 Letters Jun 2020 www.ajnr.org

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Jun 1, 2020

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