Objective To assess the role of microvascular doppler ultrasonography (MDU) combined with intraoparative indocyanine green fluorescence angiography（ICGA）in evaluating vascular patency in patients with moyamoya disease undergoing superficial temporal artery (STA) middle cerebral artery (MCA) bypass. Methods Selected 13 patients with moyamoya disease who were admitted into hospital of Xuzhou medical university from January 2017 to April 2018 and underwent STAMCA bypass surgery. Observed and analyzed the peak systolic blood flow velocity (PSV)

diastolic blood flow velocity (EDV)

resistance index (RI)

blood flow direction and blood flow spectrum morphology of the proximal and distal segments of STA

MCA before and after the intraoperative use of MDU. Fluorography was performed and the results were compared with the postoperative CTA. Results Intraoperative MDU showed that the blood flow velocity of proximal segments of M4 increased rapidly after anastomosis (P＜0.01)

the RI showed no significant change (P=0.896)

and the blood flow direction reversed;the blood flow velocity of the distal segment of M4 increased rapidly (P＜0.01)

the RI had no significant change (P=0.103); the blood flow velocity of STA increased and the RI decreased (P＜0.01)

showing an "intracranial arterialization" change in the blood flow spectrum. Intraoperative ICG angiography showed clear images

good vascular morphology and unobstructed blood flow.The postoperative CTA was consistent with the results of intraoperative MDU and fluorescein angiography. Conclusion Intraoperative microvascular doppler ultrasound combined with indocyanine green fluorescence angiography can noninvasively

repeatedly and accurately determine the vascular patency in STAMCA bypass surgery.