Abstract:Objective To explore the efficacy of combined vascular bypass of posterior cerebral artery and occipital artery in the treatment of moyamoya disease complicated with posterior circulation disease.Methods A total of 75 patients with moyamoya disease complicated with posterior circulatory disease were treated in the Department of Neurosurgery of Aviation General Hospital from September 2012 to December 2019,and the posterior circulation vascular reconstruction performed ［occipital artery-posterior cerebral artery bypass (OA-PCA)+ encephalo-duro-pericranio-synangiosis(EDPS)］in 48 cases were analyzed retrospectively.Head CT perfusion imaging was use to evaluate cerebral blood flow.According to the digital subtraction angiography (DSA) images,Preoperative intracranial vascular conditions and the establishment of collateral circulation after procedure were evaluated.Ophthalmologists assisted in visual and visual field examinations to assess the improvement of the patient′s symptoms.Results 48 patients underwent OA-PCA+EDPS surgery,of which 25 were on the left side and 23 were on the right side.None of the patients had postoperative complications.The postoperative follow up was 6-72 (24±10) months.At 6 months after surgery, CTP examination showed that cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and mean transit time (MTT) were better than those before surgery (P<0.05, P<0.01); DSA examination showed that 46(95.8%) of 48 patients had unobstructed anastomosis;42 (87.5%)of 48 patients showed the visual acuity and visual field of were improved compared with preoperative.conclusions OA-PCA+EDPS is safe and effective in treating moyamoya disease complicated with post-circulatory lesions,and can improve the visual function of patients in time.