New surgical treatment for vertebral artery pseudoaneurysm at the boundary between the V2 and V3 segments

The clinical case of a patient with a pseudoaneurysm of the left vertebral artery at the boundary between V(2) and V(3) segments after a stab wound to the neck is reported. The patient underwent a rare variant of surgical reconstruction of the vertebral artery, including resection of the vertebral artery pseudoaneurysm at the boundary between the V(2) and V(3) segments, the vertebrovertebral autovenous shunting (from the C(IV) vertebra to the C(I)-C(II) vertebrae with resection of the anterior wall of the vertebral artery canal). Postoperatively, SCT angiography revealed satisfactory blood flow in the shunt and improvement of the neurological status. The article provides a literature review on surgical procedures at the distal portion of the vertebral artery. The surgical technique was illustrated (intraoperative photos), demonstrating that the vertebral artery can be easily mobilized at any part of the V(2) segment with minimum damage to the adjacent tissues.