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Erschienen in: Acta Neurochirurgica 11/2021

23.07.2021 | How I Do it - Vascular Neurosurgery - Aneurysm

How I do it? Posterior inferior cerebellar artery-intracranial vertebral artery reimplantation bypass and trapping of dissecting aneurysm involving the proximal posterior inferior cerebellar artery

verfasst von: Zixiao Yang, Jianping Song, Peiliang Li, Wei Zhu

Erschienen in: Acta Neurochirurgica | Ausgabe 11/2021

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Abstract

Background

Proximal posterior inferior cerebellar artery (PICA) aneurysms are surgically challenging due to the high variability in the anatomy of the PICA origin, their deep-seated nature, and their entanglement with the lower cranial nerves. Direct or reconstructive clipping may not be achievable if the aneurysm is large, or dissecting, or exhibits atherosclerosis or calcification.

Method

We present a case of a proximal PICA lateral medullary segment (P2) aneurysm that was successfully cured by trapping the aneurysm and reconstructing the PICA using the PICA-intracranial vertebral artery (PICA-V4) via end-to-side reimplantation bypass with the far lateral approach.

Conclusion

This case demonstrates the feasibility and safety of PICA-V4 reimplantation bypass, especially if the origin of the PICA is highly seated and the intracranial VA, or V4 segment, is long enough and well-exposed supra or under hypoglossal nerves.
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Metadaten
Titel
How I do it? Posterior inferior cerebellar artery-intracranial vertebral artery reimplantation bypass and trapping of dissecting aneurysm involving the proximal posterior inferior cerebellar artery
verfasst von
Zixiao Yang
Jianping Song
Peiliang Li
Wei Zhu
Publikationsdatum
23.07.2021
Verlag
Springer Vienna
Erschienen in
Acta Neurochirurgica / Ausgabe 11/2021
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-021-04918-9

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