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In the first case, they performed a V<jats:sub>3<\/jats:sub>-PICA bypass using an interposition graft and then performed endovascular coil embolization of the parent VA. A complete occlusion of the aneurysm and VA was complicated by ASA thrombosis. The subsequent cases were treated with PICA-PICA bypass and subsequent endovascular embolization of the VA. Filling of the sole angiographic ASA remote from the aneurysm was preserved in both cases. The anatomy of the ASA is the most critical determinant of treatment recommendations for fusiform VA aneurysms involving PICA. When the ASA originates from the aneurysm, proximal occlusion with or without a PICA bypass is suggested. In cases in which the ASA is removed from the aneurysm, the authors recommend revascularization followed by endovascular sacrifice. When the aneurysm is immediately adjacent to the ASA, revascularization and open trapping should be considered.<\/jats:p>","DOI":"10.3171\/2018.5.jns18681","type":"journal-article","created":{"date-parts":[[2018,11,15]],"date-time":"2018-11-15T22:53:00Z","timestamp":1542322380000},"page":"1324-1330","source":"Crossref","is-referenced-by-count":4,"title":["Fusiform vertebral artery aneurysms involving the posterior inferior cerebellar artery origin associated with the sole angiographic anterior spinal artery origin: technical case report and treatment paradigm proposal"],"prefix":"10.3171","volume":"131","author":[{"given":"Kristine","family":"Ravina","sequence":"first","affiliation":[{"name":"Neurorestoration Center, Keck School of Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben A.","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Rennert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vance","family":"Fredrickson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Bakhsheshian","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Chien","sequence":"additional","affiliation":[{"name":"Neurorestoration Center, Keck School of Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Amar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Russin","sequence":"additional","affiliation":[{"name":"Neurorestoration Center, Keck School of Medicine and"},{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","article-title":"Predictive factors of medullary infarction after endovascular internal trapping using coils for vertebral artery dissecting aneurysms","author":"Aihara M","unstructured":"Aihara M, Naito I, Shimizu T, Matsumoto M, Asakura K, Miyamoto N, : Predictive factors of medullary infarction after endovascular internal trapping using coils for vertebral artery dissecting aneurysms. 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