Advertisement

Acta Neurochirurgica

, Volume 156, Issue 5, pp 971–975 | Cite as

How I do it: occipital artery to posterior inferior cerebellar artery bypass

  • Erez Nossek
  • David J. Chalif
  • Amir R. DehdashtiEmail author
How I Do it - Vascular

Abstract

Background

Aneurysms located at the proximal posterior inferior cerebellar artery (PICA) may need to be addressed by trapping and concomitant bypass. An anastomosis of the Occipital Artery (OA) to PICA is one bypass option in these cases. This bypass is highly challenging and its technical description is seldom cited in the literature.

Methods

We describe the technical nuances of an OA-PICA end-to-side bypass in a 63-year-old man with a dissecting ruptured aneurysm of the third segment (tonsilomedullary) of the PICA.

Conclusion

OA-PICA bypass option should remain as a treatment modality in the armamentarium of neurovascular surgeons.

Keywords

Cerebral bypass Occipital artery PICA Revascularization Cerebral aneurysm 

Notes

Conflict of interest

None.

Supplementary material

ESM 1

(MP4 12256 kb)

References

  1. 1.
    Ali MJ, Bendok BR, Tawk RG, Getch CC, Batjer HH (2002) Trapping and revascularization for a dissecting aneurysm of the proximal posteroinferior cerebellar artery: technical case report and review of the literature. Neurosurgery 51:258–263PubMedCrossRefGoogle Scholar
  2. 2.
    Ateş O, Ahmed AS, Niemann D, Başkaya MK (2008) The occipital artery for posterior circulation bypass: microsurgical anatomy. Neurosurg Focus 24(2):E9. doi: 10.3171/FOC/2008/24/2/E9 PubMedCrossRefGoogle Scholar
  3. 3.
    Benes L, Kappus C, Sure U, Bertalanffy H (2006) Treatment of a partially thrombosed giant aneurysm of the vertebral artery by aneurysm trapping and direct vertebral artery-posterior inferior cerebellar artery end-to-end anastomosis: technical case report. Neurosurgery 59:ONSE166–ONSE167PubMedCrossRefGoogle Scholar
  4. 4.
    Crowley RW, Medel R, Dumont AS (2009) Operative nuances of an occipital artery-to-posterior inferior cerebellar artery bypass. Neurosurg Focus 26(5):E19. doi: 10.3171/2009.2.FOCUS0911 PubMedCrossRefGoogle Scholar
  5. 5.
    Czabanka M, Ali M, Schmiedek P, Vajkoczy P, Lawton MT (2011) Vertebral artery-posterior inferior cerebellar artery bypass using a radial artery graft for hemorrhagic dissecting vertebral artery aneurysms: surgical technique and report of 2 cases. J Neurosurg 114:1074–1079PubMedCrossRefGoogle Scholar
  6. 6.
    Dehdashti AR (2013) How I do it: side to side posterior inferior cerebellar artery -posterior inferior cerebellar artery bypass procedure. Acta Neurochir. PMID: 24022600 [Epub ahead of print]Google Scholar
  7. 7.
    Fukuda H, Evins A, Burrell J, Stieg PE, Bernardo A (2013) A safe and effective technique for harvesting the occipital artery for posterior fossa bypass surgery: a cadaveric study. World Neurosurg. DOI:  10.1016/j.wneu.2013.09.015 [Epub ahead of print]
  8. 8.
    Kawashima M, Rhoton AL Jr, Tanriover N, Ulm AJ, Yasuda A, Fujii K (2005) Microsurgical anatomy of cerebral revascularization. Part II: posterior circulation. J Neurosurg 102:132–147PubMedCrossRefGoogle Scholar
  9. 9.
    Nussbaum ES, Madison MT, Myers ME, Goddard J, Janjua T (2008) Dissecting aneurysms of the posterior inferior cerebellar artery: retrospective evaluation of management and extended follow-up review in 6 patients. J Neurosurg 109:23–27PubMedCrossRefGoogle Scholar
  10. 10.
    Sundt TM Jr, Piepgras DG, Fode NC (1994) Techniques, Results, and Complications of Occipital and Temporal Artery Bypass Pedicles to Branches of the Vertebral and Basilar Arteries. In: Meyer FB (ed) Sundt’s occlusive cerebrovascular disease, 2nd edn. W.B. Saunders Company, Philadelphia, pp 456–465Google Scholar

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Erez Nossek
    • 1
  • David J. Chalif
    • 1
  • Amir R. Dehdashti
    • 1
    Email author
  1. 1.Department of NeurosurgeryHofstra North Shore–Long Island Jewish School of Medicine, and North Shore University HospitalManhassetUSA

Personalised recommendations