So, I'm not sure if I totally understand.  So, the docs are saying that one of the blood vessels in your leg is not suitable for use in a by-pass surgery? Did they say why? Size of the vessel? Quality of the vessel? Is this the same surgeon that did your other surgeries?  I hope that you find out that this was a mistake.  Have you thought about getting a second opinion? 
good luck and keep us updated,
steph

I've got to say that I'm confused about this.
I had 2 STA-MCA bypasses and the only veins they used were in my head!
I apologise for being ignorant but I have never heard of using a leg vein for this surgery? The only time my leg vein came into the equation was when I had my angio done. Anyway I do not profess to know everything about anything so I am interested to know if they do use leg veins for this?
I do however, have a problem with them using an angio that they did a couple of years before your surgery though - they should be working off an angiogram that was taken a couple of days before surgery so that they had the most up to date copy of what was going wrong.
As far as tests go there is a list on the website about tests performed before surgery, and I, myself had an MRI and angio and a SPECT BEFORE they even went near my brain!I would be seeking a second opinion on what you are going through as quite frankly I would be VERY CONCERNED about putting my fate and health in these "professionals"hands. There are plenty of medicos around who are willing to look out for their patients and as said thousands of times before on this board - You need an expert with MM experience.
Moira

I just want to echo the posts you've already recieved.  I have not heard of a leg vein being used for a moyamoya bypass surgery  (usually they use a superficial artery from the scalp region). 

As far as pre-surgery tests, usually, you have an MRI, an angiogram and SPECTS (with and without diamox -- a vasodilator) -- all of the head region.  Usually, these tests are repeated at regular intervals post-surgery.

I think it is incomrehensable that they would do a second surgery going by two-year-old tests.  I would definitely look into getting a 2nd opinion.

If you need a referral to a doctor in your area, go to the main discussion board page -- there is a page where website users recommend surgeons.  Or, start a new post here asking others for recommendations.   One warning: you may have to travel to find a qualified, exprienced moyamoya surgeon, as it is still considered a "rare" disorder.

If there is anything we can do, please don't hesitate to ask us!

Jenny (mom to Daphne www.daphnestory.com)

ahhhhhhhhh i just spent about 15 minutes writing a detailed reply to this and then my browser window vanished!!.. spewing...
i will try again...

- firstly i'll go ahead to back up helene's comment: it is quite common to consider an artery/vein from the leg for use in an DIRECT bypass.. i know that before entering the operating theatre for both my sugeries my leg was prep-ed just in case.. [ie. cleaned up etc... before i went under]

- as for determining exactly which artery will be used BEFORE surgery -> that is actually much more difficult than you'd think.. for starters, a lot of surgeons will not want to conduct another angiogram.. apart from being necessary for the diagnosis, they can be quite DANGEROUS for mm patients.. particularly if it is "close" to strokes and/or other surgeries.. (close being subjective... can be up to 2 yrs easily...) i know that my surgeon refuses to have me undertake another angiogram.. even though we're both quite "interested" in how it would look, the risks far outweigh the benefits (and often the information taken will not actually effect the decisions regarding surgery). Also, neither an MRI, CT or SPECT scan show enough detail (or the right kind of detail) to give appropriate information about the sizes/locations of arteries. so.... going into an operation the surgeon will have an idea about which artery they want to use for a direct bypass  [nominally the superficial temporal artery] however, whether this will work and where exactly it's located is different for every patient and cannot be determined until they make the incision - as you can tell by comparing the different scar locations for different mm patients. (so to answer your question about the tests that need to be done to select the appropriate artery before surgery... well there isn't much at this stage that can confirm the suitability of an artery/vein prior to surgery)..

- it is not unreasonable to expect that a number/combination of arteries may be required to complete the bypass... especially seeing as it's such a complex procedure [incl. anaesthetic] and so once "in" they are going to want to get everything they can done in one sitting, as opposed to wanting to go in again... i'm not sure about the "burn" you are referring to... that confuses me... but the "injury" on your forehead was perhaps due to another incision that had to be made? this could definitely cause a lot more pain.. esp if a skull incision had to be made also [which is most likely if they had to use other vessels to introduce more bloodflow into the brain].

- so.. while it is very unfortunate that you are still experiencing a lot of pain... 3 months down the track.. i don't think you should be freaking out too much... perhaps check in with your doctor.. have they seen the wounds? monitored the healing?

- also.. how are you feeling irrespective of the superficial injuries? has the increased bloodflow helped/been obvious yet?

it is very common - and expected! - to take anywhere from 3 months to 6 months to recover and heal from this kind of surgery.. so perhaps just be patient, take it easy and don't be too hard on yourself or your system.. and i hope this resolves soon...

i've always been told by "my" medical team that with this condition, if in doubt about how you are feeling - particular post-surgical, contact a medical practitioner of some kind!!