Subclavian-to-Extracranial Vertebral Artery Bypass in a Patient With Vertebrobasilar Insufficiency: 3-Dimensional Operative Video

2017 ◽  
Vol 14 (3) ◽  
pp. 312-312 ◽  
Author(s):  
Amol Raheja ◽  
Philipp Taussky ◽  
Ganesh S Kumpati ◽  
William T Couldwell
Keyword(s):  
Vertebral Artery ◽  
Artery Bypass ◽  
Vertebrobasilar Insufficiency ◽  
3 Dimensional ◽  
Extracranial Vertebral Artery

Carotid to distal vertebral artery bypass for vertebrobasilar ischemia

1984 ◽  
Vol 60 (1) ◽  
pp. 187-189 ◽  
Author(s):  
Perry E. Camp
Keyword(s):  
Vertebral Artery ◽  
Simple Technique ◽  
Artery Bypass ◽  
Vertebrobasilar Insufficiency ◽  
Venous Graft ◽  
Content Type ◽  
Vertebrobasilar Ischemia ◽  
Extracranial Vertebral Artery ◽  
The Common ◽  
Collateral Vessels

✓ A simple technique is described for a venous graft between the common carotid artery and the extracranial vertebral artery. In the case described, the vertebral artery was shown angiographically to be occluded and reconstituted by collateral vessels. This patient had symptoms of vertebrobasilar insufficiency which resolved postoperatively.

Subclavian to distal vertebral artery bypass

1983 ◽  
Vol 58 (4) ◽  
pp. 607-610 ◽  
Author(s):  
Howard J. Senter ◽  
Edwin T. Long
Keyword(s):  
Vertebral Artery ◽  
Simple Technique ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Vertebrobasilar Insufficiency ◽  
Content Type ◽  
Vein Bypass ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ A simple technique is described for extracranial vertebral artery vein bypass grafting, utilizing an internal shunt that avoids prohibitively dangerous vertebral artery cross-clamping. This procedure was carred out successfully in a patient with vertebrobasilar insufficiency.

Drug eluting stents versus bare metal stents for the treatment of extracranial vertebral artery disease: a meta-analysis

2015 ◽  
Vol 8 (8) ◽  
pp. 770-774 ◽  
Author(s):  
Vivek H Tank ◽  
Ritam Ghosh ◽  
Vikas Gupta ◽  
Nakul Sheth ◽  
Shariyah Gordon ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Clinical Success ◽  
Meta Analysis ◽  
Bare Metal Stents ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Vertebrobasilar Insufficiency ◽  
Bare Metal ◽  
Drug Eluting ◽  
Extracranial Vertebral Artery

BackgroundWhile a growing number of reports offer evidence for the potential of drug eluting stents (DES) in treating atherosclerotic stenosis of the extracranial vertebral artery, their efficacy when compared with bare metal stents (BMS) is uncertain due to the lack of a large prospective randomized trial.MethodsA search strategy using the terms ‘stents’, ‘drug-eluting stents’, ‘atherosclerosis’, ‘vertebral artery’, and ‘vertebrobasilar insufficiency’ was employed through Medline. Five studies met the criteria for a comparative meta-analysis. The technical/clinical success, periprocedural complications, target vessel revascularization (TVR), rates of restenosis, recurrent symptoms, and overall survival were compared.ResultsThere was no significant difference in the technical success (OR=1.528, p=0.622), clinical success (OR=1.917, p=0.274), and periprocedural complications (OR=0.741, p=0.614) between the two groups. An OR of 0.388 for no restenosis in the BMS to DES arms (p=0.001) indicated a significantly higher restenosis rate in the BMS group relative to the DES group (33.57% vs 15.49%). When compared with the DES group, the BMS group had a significantly higher rate of recurrent symptoms (2.76% vs 11.26%; OR=3.319, p=0.011) and TVR (4.83% vs 19.21%; OR=4.099, p=0.001).ConclusionsA significantly lower rate of restenosis, recurrent symptoms, and TVR was noted in the DES group compared with the BMS group.

scholarly journals Vertebrobasilar Insufficiency due to Mechanical Occlusion of Extracranial Vertebral Artery

1992 ◽  
Vol 20 (2) ◽  
pp. 143-149
Author(s):  
Toyohisa FUJITA ◽  
Hideyuki OHNISHI ◽  
Kazuo GODA ◽  
Tomonori YAMADA
Keyword(s):  
Vertebral Artery ◽  
Vertebrobasilar Insufficiency ◽  
Extracranial Vertebral Artery

scholarly journals Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

2017 ◽  
Vol 21 (3) ◽  
pp. 86
Author(s):  
D. M. Galaktionov ◽  
A. V. Dubovoy ◽  
K. S. Ovsyannikov
Keyword(s):  
Surgical Treatment ◽  
Vertebral Artery ◽  
Conflict Of Interest ◽  
Clinical Case ◽  
Artery Bypass ◽  
External Carotid Artery ◽  
External Carotid ◽  
Vertebrobasilar Insufficiency ◽  
Vertebral Artery Reconstruction ◽  
Artery Reconstruction

<p>This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.</p><p>Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.<br /><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p> </p>

OCCIPITAL ARTERY-TO-POSTERIOR INFERIOR CEREBELLAR ARTERY BYPASS FOR TREATMENT OF BILATERAL VERTEBRAL ARTERY OCCLUSION: THE ROLE OF QUANTITATIVE MAGNETIC RESONANCE ANGIOGRAPHY NONINVASIVE OPTIMAL VESSEL ANALYSIS

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. E779-E781 ◽  
Author(s):  
Robert M. Starke ◽  
Mark Chwajol ◽  
Daniel Lefton ◽  
Chandranath Sen ◽  
Alejandro Berenstein ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Artery Bypass ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Occipital Artery ◽  
Vertebrobasilar Insufficiency ◽  
Vertebral Arteries ◽  
Vertebral Artery Occlusion ◽  
Cerebellar Artery

Abstract OBJECTIVE Patients with partial or complete bilateral vertebral artery occlusion often present with signs and symptoms of transient ischemic attacks or infarction. Advances in phase contrast magnetic resonance imaging have led to noninvasive assessment of volumetric blood flow rates and direction that help in the workup and management of these patients. CLINICAL PRESENTATION We present the case of a patient with symptoms of vertebrobasilar insufficiency without previous transient ischemic attacks or stroke. Quantitative magnetic resonance angiography (QMRA) demonstrated bilateral vertebral artery occlusion with reversal of flow in the basilar and vertebral arteries to the level of the posterior inferior cerebellar arteries bilaterally. A prominent right posterior communicating artery filled the basilar artery and proximal vertebral arteries. INTERVENTION The presence of reversal and diminished flow in the basilar and vertebral arteries suggested that occipital artery-to-posterior inferior cerebellar artery bypass would improve posterior circulation, relieve symptoms, and reduce the risk of infarction. Postoperative QMRA and angiography confirmed revascularization, and QMRA confirmed correction of blood flow direction. CONCLUSION This case illustrates the potential of QMRA as part of a comprehensive cerebrovascular assessment, operative planning, and follow-up of patients with vertebrobasilar insufficiency.

scholarly journals Utility of Intraoperative Angiography during Subaxial Foramen Transversarium Decompression for Bow Hunter's Syndrome

2013 ◽  
Vol 19 (2) ◽  
pp. 240-244 ◽  
Author(s):  
D. Ding ◽  
G.U. Mehta ◽  
R. Medel ◽  
K.C. Liu
Keyword(s):  
Vertebral Artery ◽  
Head Rotation ◽  
Uncinate Process ◽  
Left Vertebral Artery ◽  
Vertebrobasilar Insufficiency ◽  
Intraoperative Angiography ◽  
Luminal Diameter ◽  
Subaxial Cervical Spine ◽  
Extracranial Vertebral Artery ◽  
Hunter's Syndrome

Bow hunter's syndrome is an uncommon cause of vertebrobasilar insufficiency resulting from rotational compression of the extracranial vertebral artery. While positional compression of any portion of the extracranial vertebral artery has been reported to result in bow hunter's syndrome, the most common site of compression is the V2 segment as it passes through the foramen transversarium of the subaxial cervical spine. A 43-year-old woman presented with increasingly frequent pre-syncopal and syncopal episodes upon leftward head rotation. Pre-operative angiographic studies with the neck rotated to the left demonstrated occlusion of the left vertebral artery by a C4-5 osteophyte arising from the C4 uncinate process. The patient underwent microsurgical decompression of the vertebral artery at C4-5 through a standard anterior transcervical retropharyngeal approach. Selective vertebral artery intraoperative angiography performed with the head passively rotated to the left before and after left vertebral artery decompression showed marked improvement in the luminal diameter and blood flow. The patient's symptoms resolved post-operatively. This case illustrates the second instance of intraoperative angiography used to confirm adequate vertebral artery decompression for bow hunter's syndrome. Intraoperative angiography can be safely used to decrease the extent of vertebral artery decompression in order to minimize the risk of operative complications.

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