scholarly journals Successful Treatment of Ruptured Dissecting Vertebral Artery Aneurysms through Proximal Occlusion of the Vertebral Artery along with Reconstruction of the Posterior Inferior Cerebellar Artery: Two Case Reports

2021 ◽  
Vol 49 (5) ◽  
pp. 401-407
Author(s):  
Michio NAKAMURA ◽  
Tadashi MIYAZAKI ◽  
Yoshihiko FUSE ◽  
Akihiko ADACHI ◽  
Tomoko YONEYAMA-SARNECKY ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Successful Treatment ◽  
Case Reports ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Proximal Occlusion

scholarly journals Fusiform vertebral artery aneurysms involving the posterior inferior cerebellar artery origin associated with the sole angiographic anterior spinal artery origin: technical case report and treatment paradigm proposal

2019 ◽  
Vol 131 (4) ◽  
pp. 1324-1330 ◽  
Author(s):  
Kristine Ravina ◽  
Ben A. Strickland ◽  
Robert C. Rennert ◽  
Vance Fredrickson ◽  
Joshua Bakhsheshian ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Endovascular Embolization ◽  
Anterior Spinal Artery ◽  
Critical Determinant ◽  
First Case ◽  
Cerebellar Artery ◽  
Treatment Paradigm ◽  
Endovascular Coil Embolization ◽  
Proximal Occlusion

Fusiform aneurysms of the vertebral artery (VA) involving the posterior inferior cerebellar artery (PICA) origin are uncommon and challenging. The anterior spinal artery (ASA) commonly originates from a unilateral ramus just distal to the PICA. Occlusion of an unpaired ASA can result in bilateral medial medullary syndrome. The authors propose a treatment paradigm for ASA preservation based on the artery’s proximity to fusiform VA aneurysms, and they present 3 representative cases. In the first case, they performed a V3-PICA bypass using an interposition graft and then performed endovascular coil embolization of the parent VA. A complete occlusion of the aneurysm and VA was complicated by ASA thrombosis. The subsequent cases were treated with PICA-PICA bypass and subsequent endovascular embolization of the VA. Filling of the sole angiographic ASA remote from the aneurysm was preserved in both cases. The anatomy of the ASA is the most critical determinant of treatment recommendations for fusiform VA aneurysms involving PICA. When the ASA originates from the aneurysm, proximal occlusion with or without a PICA bypass is suggested. In cases in which the ASA is removed from the aneurysm, the authors recommend revascularization followed by endovascular sacrifice. When the aneurysm is immediately adjacent to the ASA, revascularization and open trapping should be considered.

Intracranial Vertebral Endarterectomy

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 465-471 ◽  
Author(s):  
James I. Ausman ◽  
Fernando G. Diaz ◽  
Balaji Sadasivan ◽  
Manuel Dujovny
Keyword(s):  
Vertebral Artery ◽  
Medical Therapy ◽  
Superficial Temporal Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Temporal Artery ◽  
Superior Cerebellar Artery ◽  
Focal Lesion ◽  
Cerebellar Infarction ◽  
Vertebrobasilar Insufficiency ◽  
Cerebellar Artery

Abstract Intracranial vertebral endarterectomy was performed on six patients with vertebrobasilar insufficiency in whom medical therapy failed. The patients underwent operations for stenotic plaque in the intracranial vertebral artery with the opposite vertebral artery being occluded, hypoplastic, or severely stenosed. In four of the patients, the stenosis was mainly proximal to the posterior inferior cerebellar artery (PICA). In this group, after endarterectomy, the vertebral artery was patent in two patients, and their symptoms resolved: in one patient the endarterectomy occluded, but the patient's symptoms improved; and in one patient the endarterectomy was unsuccessful, and he continued to have symptoms. In one patient, the plaque was at the origin of the PICA. The operation appeared technically to be successful, but the patient developed a cerebellar infarction and died. In one patient the stenosis was distal to the PICA. During endarterectomy, the plaque was found to invade the posterior wall of the vertebral artery. The vertebral artery was ligated, and the patient developed a Wallenburg syndrome. The results of superficial temporal artery to superior cerebellar artery anastomosis are better than those for intracranial vertebral endarterectomy for patients with symptomatic intracranial vertebral artery stenosis. The use of intracranial vertebral endarterectomy should be limited to patients who have disabling symptoms despite medical therapy, a focal lesion proximal to the PICA, and a patent posterior circulation collateral or bypass.

Ruptured traumatic vertebral artery pseudoaneurysm in a child treated with trapping and posterior inferior cerebellar artery reimplantation

2005 ◽  
Vol 102 (2) ◽  
pp. 231-237 ◽  
Author(s):  
Brian A. O'Shaughnessy ◽  
Christopher C. Getch ◽  
Robin M. Bowman ◽  
H. Hunt Batjer
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Pseudoaneurysm ◽  
Cerebellar Artery
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