Basilar trunk aneurysm surgically treated with anterior petrosectomy and external carotid artery-to-posterior cerebral artery bypass: Technical note

OBJECTIVE: We discuss a detailed surgical technique, its indications, and potential pitfalls in its use. METHODS: A surgical procedure combining Kawase's anterior petrosectomy and external carotid artery-to-posterior cerebral artery high-flow bypass was performed for the treatment of a patient with a fusiform basilar trunk aneurysm. RESULTS: Follow-up angiography revealed the successful obliteration of the aneurysm and that the graft was functioning well. Late ischemic complications, however, occurred 5 weeks after surgery. CONCLUSION: Kawase's approach is a versatile option for safe vascular reconstruction of the posterior cerebral artery and exposure of a basilar trunk aneurysm in the upper clival region. Although, theoretically, a high-flow bypass might decrease the risk of hemodynamic ischemia, it does not prevent thromboembolic complications.