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 C1 or beyond. This technique permits exposure of the entire pars atlantica or the vertebral artery, from its exit from the foramen transversarium of C1 to its penetration of the dura mater at the foramen magnum. The experience with this technique in three patients is described.