Successful Management of Extracranial Vertebral Artery Aneurysm by Artificial Vessel Reconstruction

Unruptured extracranial vertebral artery (VA) aneurysms are uncommon and have rarely been described with treatment options. Here we report the successful reconstruction of an asymptomatic extracranial left VA aneurysm, highlighting the treatment for extracranial VA aneurysm and showing the superiority of a hybrid operating room in cerebral vascular diseases. In this 57-year-old female who had sustained an extracranial left VA aneurysm, magnetic resonance angiography showed bilateral VAs as codominant in the vertebrobasilar system. Digital subtraction angiography demonstrated that the fusiform aneurysm (18.7 × 15.4 mm) was present at the proximal part of the left VA. Aneurysm resection and vascular graft reconstruction were performed in the hybrid operating room. A successful outcome was noted at the 6-month follow-up. Extracranial VA aneurysm in the V1 segment can be well treated with open surgery using a prosthetic graft. Preserving the function of the affected VA should always be a point of concern. •Unruptured extracranial vertebral artery (VA) aneurysms are uncommon and have rarely been described with treatment options.•An extracranial VA artery aneurysm in the V1 segment can be well fixed via open surgery using a prosthetic graft.•A hybrid operating room is preferred because endovascular therapy can be performed intraoperatively if necessary.