Posterior inferior cerebellar artery reimplantation: buffer lengths, perforator anatomy, and technical limitations

Journal of Neurosurgery
Ali Tayebi MeybodiArnau Benet

Abstract

OBJECTIVE Reimplantation of the posterior inferior cerebellar artery (PICA) to the vertebral artery (VA) is a safe and effective bypass option after deliberate PICA sacrifice during the treatment of nonsaccular and dissecting aneurysms at this location. However, the anatomy and limitations of this technique have not been studied. The goal of this study was to define the surgical anatomy and buffer lengths specific to the proximal segment of the PICA related to 2 variations of PICA reimplantation: 1) reimplantation "along-VA" (simulating a dissecting VA aneurysm), and 2) reimplantation "across-VA" (simulating a nonclippable, proximal PICA aneurysm). METHODS Ten cadaver heads (20 sides) were prepared for surgical simulation. Twenty far-lateral approaches were performed. The PICA was mobilized and reimplanted onto the VA according to 2 different paradigms: 1) transposition along the axis of the VA (along-VA) to simulate a dissecting VA, and 2) transposition perpendicular to the axis of the VA (across-VA) to simulate a nonclippable, proximal PICA aneurysm. The buffer lengths provided by mobilization of the artery in each paradigm were measured and the anatomy of perforator branching on the proximal PICAs was analyzed. RESULTS The P...Continue Reading

References

Oct 1, 1986·Journal of Neurosurgery·C ShrontzH G Mirchandani
Mar 1, 1983·Journal of Neurosurgery·R J HudginsF Garcia-Bengochea
Dec 29, 2000·Acta neurochirurgica·Y KanouK Watanabe
Nov 3, 2004·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Y S ShinK G Cho
May 10, 2011·Journal of Neurosurgery·Ana Rodríguez-HernándezMichael T Lawton
Apr 25, 2012·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Susanna BacigaluppiMarco Fontanella
Feb 18, 2014·Journal of Neurosurgery·Arnau BenetJ J González Sánchez
Mar 14, 2014·The Journal of Craniofacial Surgery·Liemei GuoXiaohua Zhang
Aug 26, 2014·World Neurosurgery·Babu G Welch, H Hunt Batjer

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Citations

Oct 22, 2017·Journal of Neurointerventional Surgery·Visish M SrinivasanPeter Kan
Oct 7, 2018·Journal of Clinical Monitoring and Computing·Agnieszka UrygaMarek Czosnyka
Jul 28, 2021·Stroke; a Journal of Cerebral Circulation·Valerie VogelsVictor Volovici

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Methods Mentioned

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dissection

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