提高低龄（5~11岁）儿童烟雾病较为细小的颞浅动脉-大脑中动脉搭桥手术的成功率。

回顾性分析2017年8月至2020年7月天津医科大学总医院收治的11例5~11岁烟雾病患儿。所有患儿均采用在显微镜下“直角修剪”颞浅动脉末端、扩大吻合口面积、间断缝合统一打结等技术操作方法完成细小的颞浅动脉-大脑中动脉搭桥手术。

共完成了18侧直径＜1 mm的颞浅动脉-大脑中动脉搭桥手术。所有患儿围手术期没有出现脑出血、短暂性脑缺血发作、脑梗死等并发症，7侧进行了数字减影血管造影复查，见吻合血管通畅，颞肌贴附处也有显著的供血。

在改进的技术措施基础上，结合严格的操作训练，神经外科医师可以完成直径＜1 mm的血管吻合，使烟雾病患儿受益。

In order to evaluate the effect of small superficial temporal artery-middle cerebral artery bypass surgery on children with moyamoya disease.

We used technical methods such as "right-angle trimming" of the superficial temporal artery end under a microscope, intermittent sutures and all together knotting, and expansion of the anastomotic area, under which the tiny superficial temporal artery-middle cerebral artery bypass surgery was completed for children aged from 5 to 11 years with moyamoya disease.

A total of 11 cases of superficial temporal artery-middle cerebral artery bypass surgery with a diameter of less than 1 mm on 18 sides were completed in this group. During the perioperative period, there were no complications such as cerebral hemorrhage, transient ischemic attack (TIA), and cerebral infarction. Digital subtract angiography (DSA) was performed on 7 sides. It was found that the anastomotic vessels were unobstructed, and the temporal muscle attachment also had significant blood supply to the brain.

On the basis of improved technical measures, combined with strict operation training, neurosurgeons can complete vascular anastomoses with a diameter of less than 1 mm, which will benefit children with moyamoya disease.