Posterior Cerebral Artery-Posterior Cerebral Artery Bypass

Abstract BACKGROUND: Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications. OBJECTIVE: To describe the technique of trapping a fusiform PCA aneurysm and revascularization of the distal PCA using a superficial temporal artery (STA) graft through the same microsurgical approach. METHODS: From September 2012 to October 2014, we retrospectively identified 3 patients harboring a fusiform PCA aneurysm (P2 segment aneurysm) who underwent trapping of the aneurysm and reconstruction of the distal PCA through the same subtemporal approach. We analyzed immediate morbidity, surgical complications, and the patency of the bypass to determine the feasibility of this procedure. RESULTS: All 3 patients underwent successful trapping of the fusiform PCA aneurysm and revascularization of the distal PCA. The origin of P3 segment or posterior temporal artery (PTA) served as recipient arteries. In all 3 cases, adequate blood flow was evident after performing the STA-P3/PTA bypass. None of the patients experienced a new permanent neurological deficit. At 1-year follow-up, the STA-PTA/PCA bypasses remained patent. CONCLUSION: The STA-P3/PTA bypass through the subtemporal approach is a feasible option to maintain blood flow in cases of PCA fusiform aneurysms requiring trapping of the P2 segment.

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Superficial temporal artery to proximal posterior cerebral artery bypass through the anterior temporal approach

Surgical Neurology International ◽

10.4103/2152-7806.157949 ◽

2015 ◽

Vol 6 (1) ◽

pp. 95 ◽

Cited By ~ 15

Author(s):

Satoru Takeuchi ◽

Rokuya Tanikawa ◽

Toshiyuki Tsuboi ◽

Kosumo Noda ◽

Junpei Oda ◽

...

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Artery Bypass ◽

Superficial Temporal Artery ◽

Temporal Artery

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Occipital-posterior cerebral artery bypass via the occipital interhemispheric approach

Surgical Neurology International ◽

10.4103/2152-7806.114975 ◽

2013 ◽

Vol 4 (1) ◽

pp. 90 ◽

Cited By ~ 10

Author(s):

Ken Kazumata ◽

Yuka Yokoyama ◽

Taku Sugiyama ◽

Katsuyuki Asaoka

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Artery Bypass ◽

Interhemispheric Approach

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Internal carotid artery-to-posterior cerebral artery bypass for revascularization of the brainstem

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2015.08.007 ◽

2016 ◽

Vol 24 ◽

pp. 151-154 ◽

Cited By ~ 7

Author(s):

M. Yashar S. Kalani ◽

Robert F. Spetzler

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Cerebral Artery ◽

Internal Carotid ◽

Posterior Cerebral Artery ◽

Artery Bypass

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Occipital Artery to Posterior Cerebral Artery Bypass Using Descending Branch of the Lateral Circumflex Femoral Artery Graft for Treatment of Fusiform, Unruptured Posterior Cerebral Artery Aneurysm: 3-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opy057 ◽

2018 ◽

Author(s):

Kristine Ravina ◽

Ian A Buchanan ◽

Robert C Rennert ◽

Ben A Strickland ◽

Joseph N Carey ◽

...

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Artery Bypass ◽

Artery Aneurysm ◽

Occipital Artery ◽

3 Dimensional ◽

Artery Graft ◽

Circumflex Femoral Artery ◽

Lateral Circumflex Femoral ◽

Cerebral Artery Aneurysm

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Basilar Trunk Aneurysm Surgically Treated with Anterior Petrosectomy and External Carotid Artery-to-Posterior Cerebral Artery Bypass: Technical Note

Neurosurgery ◽

10.1097/00006123-200210000-00044 ◽

2002 ◽

Vol 51 (4) ◽

pp. 1083-1088 ◽

Cited By ~ 3

Author(s):

Shunsuke Terasaka ◽

Koji Itamoto ◽

Kiyohiro Houkin

Keyword(s):

Carotid Artery ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Artery Bypass ◽

Vascular Reconstruction ◽

External Carotid Artery ◽

Technical Note ◽

High Flow ◽

External Carotid ◽

Anterior Petrosectomy

Abstract OBJECTIVE We discuss a detailed surgical technique, its indications, and potential pitfalls in its use. METHODS A surgical procedure combining Kawase's anterior petrosectomy and external carotid artery-to-posterior cerebral artery high-flow bypass was performed for the treatment of a patient with a fusiform basilar trunk aneurysm. RESULTS Follow-up angiography revealed the successful obliteration of the aneurysm and that the graft was functioning well. Late ischemic complications, however, occurred 5 weeks after surgery. CONCLUSION Kawase's approach is a versatile option for safe vascular reconstruction of the posterior cerebral artery and exposure of a basilar trunk aneurysm in the upper clival region. Although, theoretically, a high-flow bypass might decrease the risk of hemodynamic ischemia, it does not prevent thromboembolic complications.

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