A Novel Microsurgical Procedure for Revascularization of the Vertebral Artery.

Abstract

A broad armamentarium of microsurgical techniques affords flexibility to surgeons when choosing a procedure that is best tailored to fit the anatomy of an individual. Herein, we report on the feasibility of using the deep cervical artery (DCA) to revascularize the vertebral artery (VA) via a DCA-V3 bypass graft. Fourteen DCAs from 7 injected cadaveric heads were located and traced. The diameter of the main trunk of the DCA was measured bilaterally at the C3 level. The proximal vertebral branches of each DCA were then severed and the main trunk of the DCA was transposed superiorly onto the V3 segment of the VA, which was also exposed bilaterally. The DCA was identified and traced bilaterally on all specimens. The diameter of the main trunk of the DCA at the C3 level ranged from 1.03 to 2.79 mm. The mean diameter of the main trunk of the DCA at this level was found to be 1.52 ± 0.60 mm for the right side and 1.46 ± 0.54 mm for the left side. After releasing the proximal vertebral branches of the DCA, all arteries were able to be transposed to the ipsilateral VA. Based on the mean diameter of the DCA reported in extant literature and this study, the blood flow volume of the DCA makes it a viable candidate to bypass the proximal VA.