What is the role of vertebral artery bypass in the treatment of posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

In unusual circumstances, vertebral artery bypass may be considered; however, this surgical procedure remains an unproven therapy. Extracranial (EC)-to-intracranial (IC) vertebral artery bypass may be undertaken by connection of the occipital artery to the vertebral, superior cerebellar, anterior internal carotid artery (ICA), or posterior ICA. The superficial temporal artery has also been used as a donor artery. Shunting to the posterior cerebral artery (PCA) may be accomplished by using veins or synthetic grafts. In general, EC-to-IC circulation shunting has been relegated to use in extenuating circumstances since the publication of the negative EC-IC bypass trial. [21]


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