{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T18:44:41Z","timestamp":1792262681541,"version":"4.4.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    Retrospective review of PICA aneurysms treated via intracranial bypass was performed. Outcome measurements included postoperative stroke, cranial nerve deficits, gastrostomy\/tracheostomy requirement, bypass patency, modified Rankin scale (mRS) at discharge, and mRS at 6 mo.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Seven patients with PICA aneurysms treated with intracranial bypass were identified. Five had fusiform aneurysms (4 ruptured, 1 unruptured), 1 had a giant partially thrombosed saccular aneurysm (unruptured), and 1 had a dissecting traumatic aneurysm (ruptured). Two aneurysms were at the anteromedullary segment, 4 at the lateral medullary segment, and 1 at the tonsillomedullary segment. Three patients underwent PICA-to-PICA side to side anastomoses, 2 PICA-to-PICA reanastomosis, 1 vertebral artery-to-PICA bypass, and 1 occipital artery-PICA bypass. Six out of 7 aneurysms were obliterated surgically and 1 with additional endovascular occlusion after the bypass. All bypasses were patent intraoperatively; 2 were later demonstrated occluded without radiological signs or symptoms of stroke. No patients had new cranial nerve deficit postoperatively. With the exception of 1 death due to pulmonary emboli 3 mo postoperatively, all others remain at a mRS \u2264 2.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    Constructive bypass and aneurysm obliteration remains a viable alternative for treatment of PICA aneurysms not amenable to direct surgical clipping or to a vessel-preserving endovascular option.\n                  <\/jats:p>","DOI":"10.1093\/ons\/opx064","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T19:47:33Z","timestamp":1491421653000},"page":"586-595","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":21,"title":["Intracranial Bypass of Posterior Inferior Cerebellar Artery Aneurysms: Indications, Technical Aspects, and Clinical Outcomes"],"prefix":"10.1227","volume":"13","author":[{"given":"David J.","family":"Bonda","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Labib","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Neurology, North Shore University Hospital, Northwell Health, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael A.","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lenox Hill Hospital, Northwell Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chalif","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avi","family":"Setton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Langer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, New York"},{"name":"Department of Neurosurgery, Lenox Hill Hospital, Northwell Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir R.","family":"Dehdashti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, North Shore 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