Posterior cerebral artery to superior cerebellar artery side-to-side bypass via Extreme Lateral Supracerebellar Infratentorial Approach (ELSCIT): Technical note.

BACKGROUND AND OBJECTIVE

Difficult-to-treat aneurysms of the distal posterior cerebral artery (PCA) can often be treated by parent artery occlusion. A cerebrovascular bypass can complement PCA occlusion to curb the risk of ischemic complications. An in-situ bypass may be considered when the occipital artery or superficial temporal artery cannot serve as a bypass donor. This paper describes the use of a side-to-side bypass of superior cerebellar artery (SCA) as a donor to the posterior cerebral artery (PCA) via an extreme lateral supracerebellar infratentorial (ELSCIT) approach. This bypass approach can be a useful surgical strategy for PCA revascularization.

METHODS

A 40-year-old female patient underwent a side-to-side PCA-SCA bypass via the ELSCIT approach for the treatment of a complex and previously coiled PCA aneurysm. Bypass was followed by endovascular aneurysm and parent artery occlusion.

RESULTS

Postoperatively, the patient experienced transient, partial trochlear nerve palsy of the left eye without ischemic lesions on MRI. The clinical condition was stable and angiography showed a patent bypass and complete aneurysm occlusion 12 months after surgery.

CONCLUSION

The ELSCIT-approach offers access to the medial and distal PCA that is well suitable for a side-to-side PCA-SCA bypass. This type of approach and bypass may be of value when revascularization of a P2-P3 portion of the PCA is needed, but a suitable occipital artery (OA) or superficial temporal artery (STA) is not available.

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.