Suzuki staging tracks the evolution of collateral flow via catheter angiography.
Angiogram Pattern Probe
Identify the Suzuki stage of Moyamoya disease progression to assess stroke risk and determine if revascularization surgery is indicated.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Diagnosing and staging the progression of Moyamoya disease.
Predicting the potential for ischemic vs. hemorrhagic strokes in pediatric and adult patients.
Aiding in the surgical planning for direct (STA-MCA) or indirect (EDAS/EMS) revascularisation.
Section 2
Literature
Development
Staged by Jiro Suzuki and Akira Takaku in 1969, this 6-stage classification describes the evolution of Moyamoya on digital subtraction angiography (DSA). It follows the disease from initial ICA stenosis through the peak of collateral "puff of smoke" vessels to the eventual "burnt-out" stage where the basal collateral network disappears.
Section 3
Pearls/Pitfalls
The Puff of Smoke
Stages 2 and 3 represent the height of the iconic "puff of smoke" (moyamoya) vessels. These basal vessels are fragile and prone to micro-aneurysm formation, which accounts for the high risk of haemorrhagic stroke seen in adult Moyamoya patients at these stages.
Section 4
Evidence Appraisal
Primary Reference
Cerebrovascular "moyamoya" disease. Disease showing abnormal net-like vessels in base of brain
