{'fraction_non_alphanumeric': 0.026455026455026454, 'fraction_numerical': 0.0023515579071134627, 'mean_word_length': 5.303703703703704, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Occipital Artery to Anterior Inferior Cerebellar Artery Bypass with Radial Artery Interposition Graft for Vertebrobasilar Insufficiency: 3-Dimensional Operative Video.

The occipital artery (OA) is a good donor artery for revascular-ization in patients with vertebrobasilar insufficiency because it is near recipient arteries in the posterior circulation. However, it can be difficult to harvest. This video demonstrates a salvage technique when the OA is injured, resorting to a radial artery (RA) interposition graft. A 66-year-old man presented with worsening right-sided tinnitus, instability, and falls. His right vertebral artery (VA) occluded with right posterior inferior cerebellar artery (PICA) infarcts 3 months before admission. He returned with new left cerebellum strokes while on medical management. Neuroimaging revealed infarcts in the PICA territory. Angiography showed an occluded right VA and compromised left VA flow. The left posterior communicating artery supplied the distal basilar artery, but PICA and the anterior inferior cerebellar artery (AICA) could not be visualized on either side. A left OA–AICA bypass was planned using an extended retrosigmoid craniotomy. OA was accidentally injured during muscular dissection. The OA stump was large, and RA was harvested for use as an interposition graft. A distal end-to-side anastomosis to AICA was followed by a proximal end-to-end anastomosis to the OA stump. Videoan-giography intraoperatively and catheter angiography postopera-tively showed a patent bypass with new filling of the midbasilar artery. The patient recovered well and has had no further ischemic events. This video demonstrates the use of the RA interposition