Trapping and V3–radial artery graft–V4 bypass for ruptured dissecting aneur. of the VA

Tomohiro Inoue, M.D., Akira Tamura, M.D., Ph.D., and Isamu Saito, M.D., Ph.D. Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan Abstract The authors show a surgical technique of trapping/resection of ruptured dominant vertebral artery aneurysm in conjunction with reconstruction of vertebral artery by V3–radial artery (RA) graft–V4 bypass through suboccipital craniotomy and far lateral approach. Step by step muscle dissection in posterior fossa enable fine exposure of occipital