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

摘要

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.