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This retrospective analysis was approved by the local ethics committee and was conducted in accordance with the Declaration of Helsinki.

We retrospectively identified all moyamoya patients who were treated for failed revascularization in our department between January 2007 and December 2019 including those with unilateral moyamoya and moyamoya syndrome by using the International Classification of Diseases (ICD) code 167.5 (moyamoya). Moyamoya disease (MMD), moyamoya syndrome, and unilateral MMV were defined based on the guidelines established by the Research Committee for Moyamoya Disease; and patients with possible associated diseases were classified as moyamoya syndrome patients (2). Electronic medical records were used to gather data on patient demographics; time and type of initial surgery; follow-up time; angiographic, MRI, and hemodynamic diagnostics; and clinical outcome.

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