From the Research
EDAS is the preferred surgical procedure over ELAS for treating moyamoya disease and intracranial atherosclerotic steno-occlusive disease due to its simpler technique, lower morbidity, and effective long-term outcomes in preventing strokes and improving cerebral perfusion, as demonstrated in the most recent and highest quality study 1.
Key Differences Between EDAS and ELAS
- EDAS involves placing a scalp artery directly onto the brain surface, while ELAS includes a strip of muscle tissue along with the artery.
- EDAS has a simpler technique and is more commonly performed, while ELAS may offer more robust revascularization but involves slightly more tissue manipulation.
Outcomes and Efficacy
- The study by 1 showed that EDAS significantly reduced the rate of recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease, with a rate of 10.7% compared to 37% with medical management.
- Another study by 2 demonstrated that EDAS resulted in satisfactory long-term improvement of clinical states and prevention of recurrent strokes in patients with moyamoya disease, with an annual rate of stroke of 0.73% per person-year.
Considerations for Choosing Between EDAS and ELAS
- The choice between EDAS and ELAS depends on the patient's specific condition, the surgeon's expertise, and anatomical considerations.
- Recovery typically takes several weeks, with full collateral vessel development occurring over 3-6 months.
- Both procedures have shown good long-term outcomes in preventing strokes and improving cerebral perfusion in moyamoya patients, but EDAS is generally preferred due to its simpler technique and lower morbidity.