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Acta Neurochir (Wien). 2013 Aug;155(8):1517-24; discussion 1524. doi: 10.1007/s00701-013-1715-z. Epub 2013 May 7.

Reconstruction of intracranial vertebral artery with radial artery and occipital artery grafts for fusiform intracranial vertebral aneurysm not amenable to endovascular treatment: technical note.

Author information

1
Abashiri Neurolosurgical-Rehabilitation Hospital, 4-1-7 Katsuramachi, Abashiri, Hokkaido 093-0041, Japan. kubopo@gmail.com

Abstract

BACKGROUND:

Symptomatic fusiform intracranial vertebral artery aneurysms pose a formidable treatment challenge when not amenable to endovascular treatment. In this paper, we illustrate the microsurgical management of such an aneurysm.

METHODS:

To prevent neurological deterioration, anatomical reconstruction preserving all vessels including posterior inferior cerebellar artery and perforators is essential. In this case illustration, the occipital artery was used as a donor to a perforator originating from the aneurysmal segment. This bypass was performed in an end-to-side fashion. Subsequently, the aneurysmal component of the vertebral artery was resected and an end-to-side (V4 to V3) bypass was performed using a radial artery graft.

RESULTS:

The patient achieved complete resection of the aneurysm preserving normal anatomy of the posterior circulation without any ischemic complications.

CONCLUSIONS:

Complex cerebral artery bypass techniques are essential in the armamentarium of cerebrovascular for the treatment of complex lesions not amenable to endovascular therapy.

PMID:
23649987
DOI:
10.1007/s00701-013-1715-z
[Indexed for MEDLINE]
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