Direct Surgical Treatment with OA-PICA Anastomosis for Ruptured PICA-involved Dissecting Aneurysm

Abstract

We propose a treatment for a ruptured dissecting aneurysm involving a posterior inferior cerebellar artery (PICA). The ruptured vertebral artery dissecting aneurysm is considered easy to re-bleed, so that, trapping or proximal occlusion of the aneurysm should be carried out in the acute period following subarachnoid hemorrhage. In a case with PICA originating from the aneurysm might result in cerebellar infarction. To avoid cerebellar ischemic complication, we perform occipital artery for PICA anastomosis at the time of trapping surgery.