How I Do it: side to side posterior inferior cerebellar artery –posterior inferior cerebellar artery bypass procedure

Abstract

An intracranial in situ side to side posterior circulation procedure is performed infrequently. The scope of treatment modalities of vertebral artery-PICA aneurysms and vertebral dissections is limited due to the lack of many representations of this procedure's technical nuances. To demonstrate the technical nuances of a PICA-PICA side to side bypass in a 50-year-old woman with a dissecting vertebral-PICA junction pseudoaneurysm. Details of the pre-operative evaluation, decision process and operative nuances of side to side PICA-PICA bypass are described. Indications and limitations are emphasized. Vascular neurosurgeons should consider this elegant procedure in their treatment armamentarium.