Keser Nese, Avci Emel, Soylemez Burcak, Karatas Derya, Baskaya Mustafa K
Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, USA.
World Neurosurg. 2018 Apr;112:e534-e539. doi: 10.1016/j.wneu.2018.01.073. Epub 2018 Jan 31.
To study the microsurgical anatomy of the occipital artery (OA) to determine the optimal segment for use as a conduit in revascularization bypass surgery.
Twelve sides of 6 cadaveric heads that had been injected with colored silicone were exposed using C-shaped postauricular incision. The OA was dissected from its point of origin to the proximal part of the distal segment. For each segment, the diameters and length were measured, and its branches and proximity to the recipient vessel (V3) were examined.
The mean diameters were 2.6 mm at the digastric segment, 2.04 mm at the point where it exits the mastoid sulcus, 2.0 mm, at the point just before the last descending muscular branch, and 1.8 mm and 1.5 mm after the branch and attached to the superior nuchal line, respectively. The length of the OA from the point where it exits the mastoid sulcus to the point at which it revealed the last descending muscular branch was 53 mm, and the distance of this section to the V3 was 31 mm.
In pathologies necessitating vertebral artery revascularization surgery, it is possible to easily mobilize the OA with a C-shaped postauricular incision in the lateral suboccipital region. To reach a more appropriate segment in terms of diameter, length, and easy anastomosis, V3 sulcal and OA suboccipital segments are more suitable. Thus, if bypass surgery is indicated in cases of vertebrobasilar ischemia, the suboccipital segment of the OA may be an ideal choice and considered as an artery that can be used in "SOS" conditions.
研究枕动脉（OA）的显微外科解剖结构，以确定在血管重建搭桥手术中用作血管 conduit 的最佳节段。
采用 C 形耳后切口暴露 6 具注射了彩色硅胶的尸体头部的 12 侧。将枕动脉从其起源点解剖至远段的近端部分。对每个节段测量其直径和长度，并检查其分支以及与受体血管（V3）的毗邻关系。
二腹肌段的平均直径为 2.6 mm，穿出乳突沟处为 2.04 mm，在最后一支降肌支之前的点为 2.0 mm，分支后及附着于上项线处分别为 1.8 mm 和 1.5 mm。枕动脉从穿出乳突沟处至显示最后一支降肌支处的长度为 53 mm，该段至 V3 的距离为 31 mm。
在需要椎动脉血管重建手术的病变中，通过枕下外侧区域的 C 形耳后切口可轻松游离枕动脉。就直径、长度和易于吻合而言，为了达到更合适的节段，V3 沟段和枕下枕动脉段更合适。因此，如果在椎基底动脉缺血病例中需要进行搭桥手术，枕动脉的枕下段可能是理想选择，并可被视为在“紧急情况”下可使用的动脉。
