title: Trapping and V3-radial artery graft-V4 bypass for ruptured dissecting aneurysm of the vertebral artery.
abstract: The authors show a surgical technique of trapping/resection of ruptured dominant vertebral artery aneurysm in conjunction with reconstruction of vertebral artery by V3-radial artery (RA) graft-V4 bypass through suboccipital craniotomy and far lateral approach. Step by step muscle dissection in posterior fossa enable fine exposure of occipital artery for possible OA-PICA bypass and V3 portion of vertebral artery. Extradural drilling of posterior one-third condyle and condylar fossa facilitate exposure of triangular surgical corridor made by medulla, spinal root of 11th nerve and lower cranial nerves, and thus enabling aneurismal resection and RA-V4 anastomosis. The video can be found here: http://youtu.be/LxsARGdHSVw .
authors.affiliation: Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.forename: Isamu
authors.initials: I
authors.lastname: Saito
mesh_terms: D000784:Aortic Dissection / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058017:Vascular Grafting / Q000379:methods; D014711:Vertebral Artery / Q000601:surgery* / Q000637:transplantation*
keywords: dissecting aneurysm; radial artery graft; vertebral artery