title: How I do it: occipital artery to posterior inferior cerebellar artery bypass.
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.
  
  
  CONCLUSIONS
  OA-PICA bypass option should remain as a treatment modality in the armamentarium of neurovascular surgeons.
authors.affiliation: Department of Neurosurgery, Hofstra North Shore-Long Island Jewish School of Medicine, and North Shore University Hospital, Manhasset, NY, USA.
authors.forename: Erez
authors.initials: E
authors.lastname: Nossek
authors.forename: David J
authors.initials: DJ
authors.lastname: Chalif
authors.forename: Amir R
authors.initials: AR
authors.lastname: Dehdashti
mesh_terms: D000714:Anastomosis, Surgical; D000784:Aortic Dissection / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000601:surgery*; D002531:Cerebellum / Q000098:blood supply; D002536:Cerebral Arteries / Q000601:surgery; D002548:Cerebral Revascularization / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014711:Vertebral Artery / Q000601:surgery*