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Abstract：
OBJECTIVE: To demonstrate that occipital artery (OA)-p1 posterior inferior cerebellar artery (PICA) bypass can be an alternative for complex posterior circulation aneurysms.
METHODS: A far-lateral approach to craniotomy was performed on 20 cadaveric specimens, and the OA was obtained \'in-line.\' Its length, diameter, and the number of p1/p2 and p3 segmental perforators were determined, and the relationship between the caudal loop and cerebellar tonsil position was also assessed. The distance between the PICA\'s origin and the cranial nerve XI (CN XI), the buffer length above the CN XI after dissection, the OA length required to complete the OA-p1/p3 PICA bypass, and the p1 and p3 segment diameters were all measured. A bypass training practical scale (TSIO) was used to evaluate the quality of the anastomosis.
RESULTS: All specimens underwent OA-p1 PICA end-to-end bypass and had favorable results for the TSIO score, 15 sides underwent OA-p3 PICA end-to-side bypass, and the other bypass protocols were less common. The buffer length above the CN XI after dissection, the distance between the PICA\'s origin and the CN XI, and the first perforator were all of sufficient length. The direct length of the OA needed to complete the OA-p1 PICA end-to-end bypass was significantly less than the available length and the OA-p3 PICA end-to-side bypass, with the OA matching the p1 segment diameter. The number of p1 perforators was less than that of p3, and the OA diameter was equal to that of the p1 segment.
CONCLUSIONS: OA-p1 PICA end-to-end bypass is a feasible alternative in cases in which p3 segment has high caudal loops or anatomic anomalies.
METHODS: A far-lateral approach to craniotomy was performed on 20 cadaveric specimens, and the OA was obtained \'in-line.\' Its length, diameter, and the number of p1/p2 and p3 segmental perforators were determined, and the relationship between the caudal loop and cerebellar tonsil position was also assessed. The distance between the PICA\'s origin and the cranial nerve XI (CN XI), the buffer length above the CN XI after dissection, the OA length required to complete the OA-p1/p3 PICA bypass, and the p1 and p3 segment diameters were all measured. A bypass training practical scale (TSIO) was used to evaluate the quality of the anastomosis.
RESULTS: All specimens underwent OA-p1 PICA end-to-end bypass and had favorable results for the TSIO score, 15 sides underwent OA-p3 PICA end-to-side bypass, and the other bypass protocols were less common. The buffer length above the CN XI after dissection, the distance between the PICA\'s origin and the CN XI, and the first perforator were all of sufficient length. The direct length of the OA needed to complete the OA-p1 PICA end-to-end bypass was significantly less than the available length and the OA-p3 PICA end-to-side bypass, with the OA matching the p1 segment diameter. The number of p1 perforators was less than that of p3, and the OA diameter was equal to that of the p1 segment.
CONCLUSIONS: OA-p1 PICA end-to-end bypass is a feasible alternative in cases in which p3 segment has high caudal loops or anatomic anomalies.
摘要：
目的：证明枕动脉（OA）-p1小脑后下动脉（PICA）旁路可以替代复杂的后循环动脉瘤。
方法：对20个尸体标本进行远外侧开颅手术，OA是在线获得的。\'它的长度，直径,并确定了p1/p2和p3节段穿孔器的数量，还评估了尾环与小脑扁桃体位置之间的关系。PICA的起源与颅神经XI（CNXI）之间的距离，解剖后CNXI上方的缓冲区长度，完成OA-p1/p3PICA旁路所需的OA长度，并测量了p1和p3段的直径。使用旁路训练实践量表（TSIO）评估吻合的质量。
结果：所有标本均接受了OA-p1PICA端到端旁路，并且对TSIO评分具有良好的结果，15侧接受了OA-p3PICA端到侧旁路，和其他旁路协议是不常见的。解剖后CNXI上方的缓冲区长度，PICA的原点和CNXI之间的距离，第一个穿孔器都有足够的长度。完成OA-p1PICA端到端旁路所需的OA的直接长度明显小于可用长度和OA-p3PICA端到端旁路，与OA相匹配的P1段直径。p1穿孔器的数量少于p3，OA直径等于p1段的OA直径。
结论：OA-p1PICA端对端分流术在p3段有高尾环或解剖异常的情况下是一种可行的替代方法。
方法：对20个尸体标本进行远外侧开颅手术，OA是在线获得的。\'它的长度，直径,并确定了p1/p2和p3节段穿孔器的数量，还评估了尾环与小脑扁桃体位置之间的关系。PICA的起源与颅神经XI（CNXI）之间的距离，解剖后CNXI上方的缓冲区长度，完成OA-p1/p3PICA旁路所需的OA长度，并测量了p1和p3段的直径。使用旁路训练实践量表（TSIO）评估吻合的质量。
结果：所有标本均接受了OA-p1PICA端到端旁路，并且对TSIO评分具有良好的结果，15侧接受了OA-p3PICA端到侧旁路，和其他旁路协议是不常见的。解剖后CNXI上方的缓冲区长度，PICA的原点和CNXI之间的距离，第一个穿孔器都有足够的长度。完成OA-p1PICA端到端旁路所需的OA的直接长度明显小于可用长度和OA-p3PICA端到端旁路，与OA相匹配的P1段直径。p1穿孔器的数量少于p3，OA直径等于p1段的OA直径。
结论：OA-p1PICA端对端分流术在p3段有高尾环或解剖异常的情况下是一种可行的替代方法。
