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Figure 1: Combined anastomosis. (a) Pre op MRA images showing bilateral ICA stenosis with extensive skull base moyamoya vessels. (b) post op MRA showing bilateral patent bypass. Regression of moyamoya vessels is seen bilaterally. Neo synangiosis is type A on the right side and Type B on the left side. (c) Pre op MRA of another patient showing severe stenosis of bilateral ICA with extensive basal collaterals. (d) Post op MRA after the left-sided surgery showing patent STA MCA bypass graft with regression of moyamoya collaterals and appearance of Grade B surgical synangangiotic vessels

Figure 1: Combined anastomosis. (a) Pre op MRA images showing bilateral ICA stenosis with extensive skull base moyamoya vessels. (b) post op MRA showing bilateral patent bypass. Regression of moyamoya vessels is seen bilaterally. Neo synangiosis is type A on the right side and Type B on the left side. (c) Pre op MRA of another patient showing severe stenosis of bilateral ICA with extensive basal collaterals. (d) Post op MRA after the left-sided surgery showing patent STA MCA bypass graft with regression of moyamoya collaterals and appearance of Grade B surgical synangangiotic vessels