scholarly journals Slankstelinių arterijų distalinės dalies rekonstrukcijų dažnis vertebrobazilinės išemijos atveju

2003 ◽  
Vol 1 (1) ◽  
pp. 0-0
Author(s):  
Kęstutis Laurikėnas
Keyword(s):  
Surgical Treatment ◽  
Vertebral Artery ◽  
Anatomical Changes ◽  
Vertebral Arteries ◽  
Vertebrobasilar Ischemia ◽  
Vertebrobasilar Stroke ◽  
Vilnius University ◽  
Angiographic Examination ◽  
Vertebral Artery Reconstruction ◽  
Artery Reconstruction

Kęstutis LaurikėnasVilniaus universiteto Neurologijos ir neurochirurgijos klinikaVilniaus greitosios pagalbos universitetinės ligoninėsNeuroangiochirurgijos centro Kraujagyslių chirurgijos skyrius Įvadas / tikslas Šiuo metu chirurgų požiūris į operacinio gydymo naudą slankstelinių arterijų patologijos, arba vadinamosios užpakalinės galvos smegenų kraujotakos nepakankamumo, atvejais yra gana nevienodas. Pagrindinis šio tyrimo tikslas – išsiaiškinti, kokiai įvairiomis vertebrobazilinės kraujotakos nepakankamumo formomis sergančių ligonių daliai liga yra sukelta slankstelinių arterijų užakimo ir jų stenozės kauliniuose kanaluose ir kada chirurginiam gydymui pavyksta sėkmingai pritaikyti distalinės slankstelinės arterijos dalies rekonstrukcijos operaciją. Ligoniai ir metodai Straipsnyje nagrinėjami 1677 ligonių, sergančių galvos smegenų kraujotakos išemija, tyrimo ir gydymo duomenys. Daugiausia dėmesio kreipiama į ligos struktūrą, konservatyvaus ir chirurginio gydymo metodų taikymo dažnį. Rezultatai Nustatyta, jog 75 % (1259 ligoniai) visų šių stacionare gydytų galvos smegenų kraujotakos sutrikimų sudarė vertebrobazilinės kraujotakos nepakankamumas, kuris dažniau pasitaiko moterims (66,4 %). Vertebrobazilinis insultas yra dažnesnis nei praeinantys kraujotakos sutrikimai ir sudaro 65,5 % (825 stacionaro ligoniai) vertebrobazilinės kraujotakos nepakankamumo atvejų. Patomorfologiniai slankstelinių arterijų pokyčiai nustatyti tik 720 ligonių, kuriems buvo vertebrobazilinė simptomatika (57,2 % šios ligos atvejų). Mūsų duomenimis, miego arterijų stenozė buvo susijusi su vertebrobaziline simptomatika tik 93 (7,4 %) ligoniams iš 1259 vertebrobazilinės išemijos atvejų. Išvados Operacinis gydymas buvo indikuojamas tik 298 (23,7 %) ligoniams, sergantiems vertebrobaziliniu kraujotakos nepakankamumu. Slankstelinės arterijos distalinės dalies rekonstrukcija atlikta 15 ligonių ir šios operacijos sudarė 5,1 % visų slankstelinių arterijų rekonstrukcinių operacijų. Jos atliktos tik 1,2 % ligonių, turinčių vertebrobazilinę simptomatiką. Prasminiai žodžiai: slankstelinė arterija, vertebrobazilinė išemija, chirurginis gydymas, slankstelinės arterijos distalinės dalies rekonstrukcija. Distal vertebral artery reconstruction: surgical possibilities in vertebrobasilar ischemia Kęstutis Laurikėnas Background / objective This study highlights the rate of surgical activities in cases of vertebrobasilar ischemia. Patients and methods In the last years in the neurological and vascular surgery clinics of Vilnius University Emergency Hospital 1259 patients were treated for vertebrobasilar ishemia and 298 patients (23.7%) underwent vertebral artery reconstruction. Results Only in 57.2% of cases of vertebrobasilar ishemia did we find pathological anatomical changes in vertebral arteries. In 83 cases the vertebral artery was occluded, in 413 cases vertebral arteries were herniated into canalis osseus by osteochondrosis. In 825 cases (65.5%) vertebrobasilar stroke occurred. Conclusions After CT and angiographic examination only 15 distal vertebral artery reconstructions were performed, i. e. 5.1% of all operations on vertebral artery and 1.2% of all vertebrobasilar patients. Keywords: vertebral artery, vertebrobasilar ishemia, surgical treatment, distal vertebral artery reconstruction.

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>

Angiographic Examination and Surgical Treatment of Bow Hunter's Stroke

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Junya Hanakita ◽  
Hidenori Miyake ◽  
Shinji Nagayasu ◽  
Shyogo Nishi ◽  
Takanori Suzuki
Keyword(s):  
Surgical Treatment ◽  
Vertebral Artery ◽  
Dura Mater ◽  
Surgical Procedure ◽  
Cervical Vertebrae ◽  
Head Rotation ◽  
Head Motion ◽  
Vertebral Arteries ◽  
Angiographic Examination ◽  
Bow Hunter’S Stroke

ABSTRACT Anatomically, the vertebral artery courses through six foramina transversaria of the cervical vertebrae, passing through the groove on the surface of the arch of the atlas and then penetrating the dura mater. Because of this anatomical course, the vertebral arteries are often affected by head motion. Stenotic change of the vertebral artery can occur at the atlantoaxial level in head rotation. Such a special type of stroke was named “bow hunter's stroke” by Sorensen. We report three cases of bow hunter's stroke and discuss the angiographic examinations. As surgical treatment, we performed partial transversectomy of the atlas vertebra, with favorable results. The usefulness of this surgical procedure is discussed.

Rotational Vertebrobasilar Ischemia: Hemodynamic Assessment and Surgical Treatment

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Marcelo D. Vilela ◽  
Robert Goodkin ◽  
David A. Lundin ◽  
David W. Newell
Keyword(s):  
Surgical Treatment ◽  
Vertebral Artery ◽  
Transcranial Doppler ◽  
Posterior Circulation ◽  
Long Term Results ◽  
Vertebrobasilar Insufficiency ◽  
Head Turning ◽  
Vertebrobasilar Ischemia ◽  
Hemodynamic Assessment ◽  
Vertebral Artery Compression

Abstract OBJECTIVE: Rotational vertebrobasilar insufficiency is a severe and incapacitating condition. Proper investigation and management are essential to reestablish normal posterior circulation hemodynamics, improve symptoms, and prevent stroke. We present a series of 10 patients with rotational vertebrobasilar ischemia who were treated surgically and emphasize the importance of transcranial Doppler in the diagnosis and management of this condition. METHODS: All patients presented with symptoms of vertebrobasilar insufficiency induced by head turning. Transcranial Doppler documented a significant decrease in the posterior cerebral artery velocities during head turning that correlated with the symptoms in all patients. A dynamic cerebral angiogram was performed to demonstrate the site and extent of vertebral artery compression. RESULTS: The surgical technique performed was tailored to each individual patient on the basis of the anatomic location, pathogenesis, and mechanism of the vertebral artery compression. Five patients underwent removal of osteophytes at the level of the subaxial cervical spine, one patient had a discectomy, two patients had a decompression only at the level of C1–C2, and two patients had a decompression and fusion at the C1–C2 level. CONCLUSION: The transcranial Doppler is extremely useful to document the altered hemodynamics preoperatively and verify the return of normal posterior circulation velocities after the surgical decompression in patients with rotational vertebrobasilar ischemia. Surgical treatment is very effective, and excellent long-term results can be expected in the vast majority of patients after decompression of the vertebral artery.

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