Far Lateral Craniotomy, OA-PICA Bypass, and Trapping of a Ruptured Dissecting Fusiform Right Vertebral Artery Aneurysm Involving the PICA Origin

Ruptured dissecting vertebral artery aneurysms carry a high mortality rate. Bypass techniques are critical to replace flow when the aneurysm involves the PICA origin. A 44-year-old male presented with a Hunt Hess grade IV subarachnoid hemorrhage. Imaging identified a dissecting fusiform right VA aneurysm incorporating the PICA origin. A far lateral craniotomy, direct occipital artery to PICA bypass, and complete trapping of the diseased vasculature were performed. Follow-up imaging showed complete aneurysm obliteration with a patent bypass.

Publication History

Article published online:
01 February 2023