TY - JOUR
T1 - Cerebral revascularization performed using posterior inferior cerebellar artery-posterior inferior cerebellar artery bypass
T2 - Report of four cases and literature review
AU - Lemole, G. Michael
AU - Henn, Jeffrey
AU - Javedan, Sam
AU - Deshmukh, Vivek
AU - Spetzler, Robert F.
PY - 2002
Y1 - 2002
N2 - Cerebral revascularization is often required for the surgical treatment of complex intracranial aneurysms. In certain anatomical locations, vascular anatomy and redundancy make in situ bypass possible. The authors present four patients who underwent revascularization performed using the rarely reported posterior inferior cerebellar artery (PICA)-PICA in situ bypass after their aneurysms had been trapped. At Barrow Neurological Institute, between 1991 and the present, four male patients underwent PICA-PICA bypasses to treat aneurysms involving the vertebral artery, the PICA, or both. The mean age of these patients was 34 years (range 5-49 years). Follow-up studies revealed patent bypasses and no evidence of infarction. Patient outcomes were excellent or good. Multiple surgical techniques have been described for revascularization of at-risk cerebral territories. Often, the blood supply must be derived from extracranial sources through a mobilized pedicle or interposited graft. Certain anatomical locations such as the vertebrobasilar junction, the anterior circle of Willis, and the middle cerebral artery bifurcation are amenable to in situ bypass because there is vessel redundancy or proximity to the contralateral analogous vessel. The advantages of an in situ bypass include one suture line, a short bypass distance, and a close match with the caliber of the recipient graft. Although technically challenging, this technique can be successful and should be considered for appropriate candidates.
AB - Cerebral revascularization is often required for the surgical treatment of complex intracranial aneurysms. In certain anatomical locations, vascular anatomy and redundancy make in situ bypass possible. The authors present four patients who underwent revascularization performed using the rarely reported posterior inferior cerebellar artery (PICA)-PICA in situ bypass after their aneurysms had been trapped. At Barrow Neurological Institute, between 1991 and the present, four male patients underwent PICA-PICA bypasses to treat aneurysms involving the vertebral artery, the PICA, or both. The mean age of these patients was 34 years (range 5-49 years). Follow-up studies revealed patent bypasses and no evidence of infarction. Patient outcomes were excellent or good. Multiple surgical techniques have been described for revascularization of at-risk cerebral territories. Often, the blood supply must be derived from extracranial sources through a mobilized pedicle or interposited graft. Certain anatomical locations such as the vertebrobasilar junction, the anterior circle of Willis, and the middle cerebral artery bifurcation are amenable to in situ bypass because there is vessel redundancy or proximity to the contralateral analogous vessel. The advantages of an in situ bypass include one suture line, a short bypass distance, and a close match with the caliber of the recipient graft. Although technically challenging, this technique can be successful and should be considered for appropriate candidates.
KW - Cerebral revascularization
KW - In situ bypass procedure
KW - Posterior inferior cerebellar artery
UR - http://www.scopus.com/inward/record.url?scp=0036289466&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036289466&partnerID=8YFLogxK
U2 - 10.3171/jns.2002.97.1.0219
DO - 10.3171/jns.2002.97.1.0219
M3 - Article
C2 - 12134919
AN - SCOPUS:0036289466
SN - 0022-3085
VL - 97
SP - 219
EP - 223
JO - Journal of neurosurgery
JF - Journal of neurosurgery
IS - 1
ER -