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.