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Updated: Jun 4, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
How I do it: Endoscopic microvascular decompression with vertebral artery transposition for trigeminal neuralgia
Viktoriia Kuts-Karpenko1, Fuminari Komatsu2, Yoko Kato2
1Department of Neurosurgery, Municipal Non-Profit Enterprise "Lviv Territorial Medical Union Multidisciplinary Clinical Hospital of Emergency and Intensive Care" (First Lviv Territorial Medical Union), 9 I. Mykolaychuka St., Lviv, Ukraine. vika.kutskarpenko29@gmail.com.
Background:
Vertebrobasilar dolichoectasia (VBDE) is an uncommon cause of trigeminal neuralgia (TN), in which an ectatic vertebral artery (VA) compresses the root entry zone (REZ), while perforators may limit safe transposition.
Methods:
Fully endoscopic microvascular decompression with VA transposition was performed. Preservation of all arterial branches was achieved and confirmed endoscopically.
Conclusion:
In VBDE-related TN, VA transposition may be the preferred decompressive strategy because of the characteristics of the ectatic vessel. Endoscopy offers a wide-angle view of the REZ, facilitating safe mobilization under full visualization of branch vessels.
