Abstract：
To assess the posterior inferior cerebellar artery (PICA)-PICA bypass possibility.
Fifteen adult cadaver heads were used for surgical simulation, and the far-lateral approach was used to expose the surgical field. The bilateral PICA course, diameter, and perforators were observed and measured to evaluate the possibility of a PICA-PICA bypass.
The PICA-PICA bypass was performed in seven (46.7 %) of the 15 specimens; the procedure was performed easily in three specimens, a little difficult in two, and was difficult in two specimens because of the relationship between the tonsil and the short parallel length of the bilateral tonsillomedullary (p3) segment. In eight (53.3 %) of the 15 specimens, PICA-PICA bypass was not feasible for reasons including 1) the caliber of the bilateral p3 was unmatched for bypass, 2) the distance of bilateral p3 in the midline was > 7 mm, 3) the middle segment of p3 perforating direct arteries limited the buffer length, and 4) single caudal loops.
The possibility of PICA-PICA bypass was determined by the proximity of the bilateral p3, caliber match, and mobilization of the bilateral caudal loop due to the perforators. The difficulty of the PICA-PICA bypass mainly depends on the relationship between the cerebellar tonsil and the parallel length of the bilateral PICA in the midline.
Fifteen adult cadaver heads were used for surgical simulation, and the far-lateral approach was used to expose the surgical field. The bilateral PICA course, diameter, and perforators were observed and measured to evaluate the possibility of a PICA-PICA bypass.
The PICA-PICA bypass was performed in seven (46.7 %) of the 15 specimens; the procedure was performed easily in three specimens, a little difficult in two, and was difficult in two specimens because of the relationship between the tonsil and the short parallel length of the bilateral tonsillomedullary (p3) segment. In eight (53.3 %) of the 15 specimens, PICA-PICA bypass was not feasible for reasons including 1) the caliber of the bilateral p3 was unmatched for bypass, 2) the distance of bilateral p3 in the midline was > 7 mm, 3) the middle segment of p3 perforating direct arteries limited the buffer length, and 4) single caudal loops.
The possibility of PICA-PICA bypass was determined by the proximity of the bilateral p3, caliber match, and mobilization of the bilateral caudal loop due to the perforators. The difficulty of the PICA-PICA bypass mainly depends on the relationship between the cerebellar tonsil and the parallel length of the bilateral PICA in the midline.
摘要：
目的：评估小脑后下动脉（PICA）-PICA旁路的可能性。
方法：使用15个成人尸体头进行手术模拟，并采用远外侧入路暴露手术野。双边PICA课程，直径,观察和测量射孔器，以评估PICA-PICA旁路的可能性。
结果：在15个标本中的7个（46.7％）中进行了PICA-PICA旁路；该程序在三个标本中很容易进行，两个有点困难，由于扁桃体和双侧扁桃体髓质（p3）节段的平行长度短之间的关系，在两个标本中很困难。在15个样本中的8个(53.3%)中，PICA-PICA旁路不可行，原因包括：1）双侧p3的口径与旁路无关，2)双侧P3在中线的距离>7mm,3)p3穿直动脉的中段限制了缓冲液的长度，和4)单尾环。
结论：PICA-PICA旁路的可能性取决于双侧p3，口径匹配，以及由于射孔器引起的双侧尾环动员。PICA-PICA旁路的难度主要取决于小脑扁桃体与中线双侧PICA平行长度之间的关系。
方法：使用15个成人尸体头进行手术模拟，并采用远外侧入路暴露手术野。双边PICA课程，直径,观察和测量射孔器，以评估PICA-PICA旁路的可能性。
结果：在15个标本中的7个（46.7％）中进行了PICA-PICA旁路；该程序在三个标本中很容易进行，两个有点困难，由于扁桃体和双侧扁桃体髓质（p3）节段的平行长度短之间的关系，在两个标本中很困难。在15个样本中的8个(53.3%)中，PICA-PICA旁路不可行，原因包括：1）双侧p3的口径与旁路无关，2)双侧P3在中线的距离>7mm,3)p3穿直动脉的中段限制了缓冲液的长度，和4)单尾环。
结论：PICA-PICA旁路的可能性取决于双侧p3，口径匹配，以及由于射孔器引起的双侧尾环动员。PICA-PICA旁路的难度主要取决于小脑扁桃体与中线双侧PICA平行长度之间的关系。
