Note: occasionally, a small vertebral artery will terminate into a common AICA-PICA complex. The posterior inferior cerebellar artery gives off the following arteries: ![]() Supplies the vermis and adjacent hemisphere The main trunk of the posterior inferior cerebellar artery usually bifurcates somewhere along the margin of the cerebellar tonsil into ![]() Supplies branches to the cerebellar surface Marks the transition between the proximal (medulla-supplying) and distal (cerebellum-supplying) parts of the posterior inferior cerebellar arteryĬourses in the cleft between the tela choroidea, inferior medullary velum rostrally, and superior pole of the cerebellar tonsil caudallyĬontains the cranial loop, also known as the choroid point or choroid arch, an upward convex loop that has a constant relation to the 4 th ventricle and gives rise to choroidal arteries Variably courses (ascending or descending) along the side of the medulla near or between the origins of the 9 th, 10 th, and 11 th cranial nerve rootsĬourses along the posterolateral surface of the medulla and inferior cerebellar tonsilĬontains the caudal loop, a downward convex loop that mostly remain superior to the foramen magnum but occasionally extend below it 6,7:Ĭourses along the front of the medulla at the level of the inferior olive The segmental anatomy was defined microsurgically by Lister et al. Occasionally arises from a common origin with the anterior inferior cerebellar artery ~20% arise extracranially, inferior to the foramen magnumġ0% arise from the basilar rather than vertebral artery Bihemispheric PICA crosses midline and typically serves both PICA territories. All rights reserved.The PICA is a paired artery that originates from the vertebral artery V4 segment. Purpose Although the anatomic course of the posterior interior cerebellar artery (PICA) is variable, it is thought to be very rare for the artery to cross midline, with an estimated incidence of 0.1. The findings of this study indicate the need for a higher concentration of CABG programs, as well as the publication of risk-adjusted outcomes of coronary intervention.Ĭirugía de revascularización aortocoronaria Coronary artery bypass grafting Hospital mortality Mortalidad hospitalaria Readmissions Reingreso Volume Volumen.Ĭopyright © 2019 Sociedad Española de Cardiología. Higher volume was associated with better outcomes in CABG, both total and isolated. The mean CABG volume is low in Spanish National Health System hospitals. The same association between volume and more favorable outcomes was found in isolated CABG. Episodes attended in low-volume centers for CABG (< 155 CABG per year) showed 17% higher RAMR (5.81%☒.07% vs 4.96%☑.76% P <.001) and a negative linear correlation between volume and RARR (r=-0.318 P=.029), as well as a higher percentage of complications during the episode. High- and low-volume hospitals for CABG were identified by a nonconditioned analysis (k-means) and by compliance with the volume recommendation of clinical practice guidelines.Ī total of 17 335 CABG index episodes were included, with a crude in-hospital mortality rate of 5.0%. Risk-adjusted rates of in-hospital mortality (RAMR) and 30-day readmissions (RARR) were calculated using multilevel logistic regression. The selected outcome variables were in-hospital mortality in the index episode, 30-day cardiac-related readmissions, and mortality during readmission. 1) Many cases of PICA aneurysms are nonsaccular or fusiform aneurysms in which a simple clipping technique cannot be applied, and trapping surgery with vascular reconstruction is often required. ![]() We analyzed CABG episodes from 2013 to 2015. Posterior inferior cerebellar artery (PICA) aneurysms are rare and account for only 3-4 of all brain aneurysms. To analyze the association between volume and outcomes in coronary artery bypass grafting (CABG) in the Spanish National Health System.
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