Occipital artery ⁃ posterior inferior cerebellar artery bypass for the treatment of vertebral aneurysms involving posterior inferior cerebellar artery

Abstract

Objective To assess the efficacy of occipital artery (OA)⁃posterior inferior cerebellar artery (PICA) bypass for the treatment of vertebral aneurysms involving PICA. Methods and Results A total of 6 patients with vertebral aneurysms involving PICA treated by OA⁃PICA bypass in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to December 2020 were retrospectively reviewed. Complications were recorded and outcomes were assessed by modified Rankin Scale (mRS). OA⁃PICA bypass was successfully performed in 6 patients and bypass patency was confirmed by intraoperative indocyanine green angiography (ICGA). OA⁃PICA bypass and surgical trapping were performed in the same session in one patient (Case 4). Elective endovascular trapping was applied after bypass in 3 cases (Case 1, Case 3, Case 5). Elective stent implantation was conducted in one patient (Case 2) after the bypass surgery. One patient (Case 6) died of aneurysm rehemorrhage 10 h after OA⁃PICA bypass. No complications were observed during the hospitalization in the remaining 5 patients. Bypass patency was achieved in a mean follow⁃up time of 37 months and outcome was favorable (mRS was 1, for all) one year after the final surgery. Conclusions OA ⁃ PICA bypass is an effective method for the treatment of PICA⁃involved vertebral aneurysms.

Keywords

• carotid artery external
• cerebellum
• arteries
• cerebral revascularization
• aneurysm
• vertebral artery
• cerebral angiography