Suboccipital approach to the distal vertebral artery

A technique to expose directly the pars atlantica or the vertebral artery through a posterior approach was studied. It is useful when dealing with occlusive, aneurysmal, or dissecting, lesions that extend to the transverse process of Cl or beyond. This technique permits exposure of the entire pars atlantica or the vertebral artery, from its exit from the foramen transversarium of Cl to its penetration of the dura mater at the foramen magnum. The experience with this technique in three patients is described.