Aneurysms associated with мoyamoya angiopathy

The prevalence of intracranial arterial aneurysms associated with мoyamoya angiopathy (AA-MMA) is five times higher than in the general population. The rupture risk of AA-MMA can reach 90 %. The application of standard surgical methods for aneurysm treatment without considering the features of мoyamoya angiopathy may lead to adverse consequences for patients. Therefore, the development of a surgical strategy algorithm for AA-MMA treatment is highly relevant. The aim of this work is to analyze the experience of treating AA-MMA as presented in the global scientific literature, to evaluate the advantages and disadvantages of various treatment methods. The paper also discusses key aspects, including current data on prevalence, etiopathogenetic theories of AA-MMA formation and classification. A search for scientific sources was conducted in journals reviewed by the Higher Attestation Commission and included in the international database Scopus, as well as in information systems and databases such as PubMed, Scopus, MEDLINE, Cochrane Library, and eLIBRARY.RU. Publications in both english and russian were included in the analysis. There was no limitation on the age of sources. We proposed a surgical treatment algorithm for AA-MMA based on data from scientific literature. Additionally, the article presents an improved topographic classification according to the most common anatomical locations, taking into account the high predisposition to rupture. The surgical strategy algorithm presented in this study may serve as a guide for treating patients with AA-MMA.