title: Reconstruction of intracranial vertebral artery with radial artery and occipital artery grafts for fusiform intracranial vertebral aneurysm not amenable to endovascular treatment: technical note.
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.
authors: Abashiri Neurolosurgical-Rehabilitation Hospital, 4-1-7 Katsuramachi, Abashiri, Hokkaido 093-0041, Japan. kubopo@gmail.com
authors: Hisashi
authors: H
authors: Kubota
authors: Rokuya
authors: R
authors: Tanikawa
authors: Makoto
authors: M
authors: Katsuno
authors: Kosumo
authors: K
authors: Noda
authors: Nakao
authors: N
authors: Ota
authors: Shiro
authors: S
authors: Miyata
authors: Tomonari
authors: T
authors: Yabuuchi
authors: Naoto
authors: N
authors: Izumi
authors: Ketan R
authors: KR
authors: Bulsara
authors: Masaaki
authors: M
authors: Hashimoto
mesh_terms: D000783:Aneurysm / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D019635:Neurosurgical Procedures; D017534:Radial Artery / Q000637:transplantation*; D014711:Vertebral Artery / Q000601:surgery*