Introduction: Complex aneurysm of the posterior circulation can be treated with clipping surgery or endovascular coiling. However, several numbers of patients with complex aneurysm will not ineligible for conventional treatment and these patients require alternative strategy such as combined treatment. Here, the authors report their experiences with six consecutive cases of this kind of aneurysm and discuss a significant role of bypass technique for treatment of these complex aneurysms.
Methods: During the past 6 years, 6 cases of aneurysm arising from vertebral artery or its branches were treated with OA-PICA bypass. In this study, we analyzed clinical information, characteristics of aneurysms and results of operation.
Results: There are two VA aneurysms and four PICA aneurysms. Four of them were ruptured aneurysms. And two cases were recurrent aneurysms after endovascular embolization. OA-PICA bypass was performed before clipping or trapping of aneurysm in all patients. Postoperative angiography revealed patent OA-PICA bypass in 5 patients (83% success rate for bypass). And aneurysms were completely obliterated in three cases. Two of three residual aneurysms were treated with additional endovascular coiling after the operation. All patients recovered without neurologic deficits postoperatively.
Conclusions: OA-PICA bypass with trapping of aneurysm is an important technique for treatment of complex aneurysm of the vertebral artery or its branches.
Patient Care: Several vertebral artery and its branches aneurysms were not adequate to conventional microsurgical clipping or coil embolization. We treated complex vertebral artery and its branches aneurysms using combined treatment OA-PICA bypass. We obtained result that effective aneurysm obliteration and favorable patients' functional outcome
Learning Objectives: Identify an effective and safe treatment of vertebral artery and its branches' complex aneurysm