Suboccipital approach to the distal vertebral artery

A technique to expose directly the pars atlantica or the vertebral artery t hrough a posterior approach was studied. It is useful when dealing with occ lusive, aneurysmal, or dissecting, lesions that extend to the transverse pr ocess of Cl or beyond. This technique permits exposure of the entire pars a tlantica or the vertebral artery, from its exit from the foramen transversa rium of Cl to its penetration of the dura mater at the foramen magnum. The experience with this technique in three patients is described.