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Acta Neurochirurgica

, Volume 155, Issue 8, pp 1517–1524 | Cite as

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

  • Hisashi KubotaEmail author
  • Rokuya Tanikawa
  • Makoto Katsuno
  • Kosumo Noda
  • Nakao Ota
  • Shiro Miyata
  • Tomonari Yabuuchi
  • Naoto Izumi
  • Ketan R. Bulsara
  • Masaaki Hashimoto
Technical Note - Vascular

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.

Keywords

Fusiform intracranial vertebral artery aneurysm Vertebral artery reconstruction Radial artery Occipital artery Perforator Bypass 

Notes

Conflicts of interest

None.

Supplementary material

ESM 1

(MPG 167156 kb)

ESM 2

(MPG 196896 kb)

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Hisashi Kubota
    • 1
    Email author
  • Rokuya Tanikawa
    • 1
  • Makoto Katsuno
    • 1
  • Kosumo Noda
    • 1
  • Nakao Ota
    • 1
  • Shiro Miyata
    • 1
  • Tomonari Yabuuchi
    • 1
  • Naoto Izumi
    • 1
  • Ketan R. Bulsara
    • 2
  • Masaaki Hashimoto
    • 1
  1. 1.Abashiri Neurolosurgical-Rehabilitation HospitalAbashiriJapan
  2. 2.Department of NeurosurgeryYale University School of MedicineNew HavenUSA

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