To analyze the clinical efficacy of intracranial-extracranial bypass surgery for the treatment of posterior circulation aneurysms.

A retrospective analysis was conducted on the clinical data of six patients with posterior circulation aneurysms who underwent intracranial and extracranial vascular bypass surgery in the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from May 2020 to February 2023. All patients completed imaging evaluation, cerebral blood flow compensation function evaluation, and clinical grading evaluation of subarachnoid hemorrhage before surgery. Intracranial and extracranial vascular bypass surgery was performed, and the blood supply artery was the occipital artery or radial artery. Postoperative head and neck CTA was used to observe the patency of bridging vessels, and the modified Rankin scale (mRS) was used to evaluate the patients' prognosis.

Among the 6 patients with posterior circulation aneurysms, 2 cases were located in the posterior inferior cerebellar artery, 2 cases in the basilar artery, 1 case in the vertebral artery, and 1 case in the posterior cerebral artery. Among them, 3 cases of ruptured aneurysms were manifested as subarachnoid hemorrhage. Intraoperative ICG imaging or vascular ultrasound showed patency of the bridging vessel in all patients; 1 patient had postoperative occlusion of the bridging vessel, brainstem infarction, and ultimately died of a severe pulmonary infection, and 1 patient developed mild limb paralysis. Five patients were followed up for 6-24 months, and the mRS score was 0 to 2 points.

Intracranial-extracranial bypass surgery is an effective modality to treat posterior circulation aneurysms, with high patency rate and good prognosis.