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: Combined treatment with OA-PICA for the complex posterior circulation aneurysms that ineligible for conventional clipping and endovascular coiling showed effective aneurysmal obliteration and favorable patients' functional outcome. So, we adopted this treatment for complex aneurysm of vertebral artery and its branches.
Learning Objectives: Identify an effective treatment of the complex aneurysm of the vertebral artery and its branches.