Tandem Bypass: Occipital Artery to Posterior Inferior Cerebellar Artery Side-to-Side Anastomosis and Occipital Artery to Anterior Inferior Cerebellar Artery End-to-Side Anastomosis—a Case Report

A unique example of posterior fossa revascularization is presented. A tandem bypass was performed by anastomosing the midoccipital artery to the posterior inferior cerebellar artery in a side-to-side fashion followed by anastomosis of the distal occipital artery to the anterior inferior cerebellar artery in an end-to-side fashion. The operation was designed to revascularize two separate vascular territories that were isolated in a patient thought to have an extremely compromised posterior circulation. The patient is doing well and is asymptomatic 3 years postoperatively.