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>

scholarly journals Cervical Vertebral Artery to Facial Branch External Carotid Artery Bypass: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Benjamin K Hendricks ◽  
Robert F Spetzler
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Artery Bypass ◽  
Video Recording ◽  
Distal Segment ◽  
External Carotid Artery ◽  
External Carotid ◽  
Transverse Foramen ◽  
Institutional Review ◽  
V1 Segment

Abstract Posterior circulation ischemia often presents with dizziness, ataxia, visual disturbances, or motor-sensory deficits. The vertebral artery stenosis most frequently involves the V1 segment proximal to the foraminal segment. This patient demonstrated critical stenosis of the left V1 segment of the vertebral artery related to atherosclerotic disease. A left cervical dissection was performed, and the cervical transverse foramen was opened to permit exposure of the vertebral artery in the V2 segment. The vertebral artery was proximally occluded and transected. An endarterectomy was performed, and an end-to-end anastomosis of the facial branch of the external carotid artery to the distal segment of the transected vertebral artery was completed. Indocyanine green angiography was used to confirm patency of the anastomosis. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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.

Giant thrombosed vertebral artery aneurysm managed with extracranial-intracranial bypass surgery and aneurysmectomy

1992 ◽  
Vol 77 (4) ◽  
pp. 624-627 ◽  
Author(s):  
Kenji Wakui ◽  
Shigeaki Kobayashi ◽  
Toshiki Takemae ◽  
Yukihiro Kamijoh ◽  
Hisashi Nagashima ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Bypass Surgery ◽  
Posterior Cerebral Artery ◽  
Clinical Course ◽  
Artery Bypass ◽  
Artery Aneurysm ◽  
External Carotid Artery ◽  
External Carotid ◽  
Arterial Graft ◽  
Content Type

✓ A case is presented of a left giant thrombosed vertebral artery aneurysm in a 46-year-old man. The giant thrombosed aneurysm was successfully resected with trapping of the affected artery after right external carotid artery-posterior cerebral artery bypass surgery using a radial arterial graft. The clinical course is reported, and the details of the operative approach and techniques are discussed.

External Carotid Artery-to-Middle Cerebral Artery Bypass Using a Saphenous Vein Graft With 3-Vessel Anastomosis for the Treatment of a Large, Ruptured Middle Cerebral Artery Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Kristine Ravina ◽  
Joshua Bakhsheshian ◽  
Joseph N Carey ◽  
Jonathan J Russin
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Artery Aneurysm ◽  
External Carotid Artery ◽  
External Carotid ◽  
Bifurcation Aneurysm

Abstract Cerebral revascularization is the treatment of choice for select complex intracranial aneurysms unamenable to traditional approaches.1 Complex middle cerebral artery (MCA) bifurcation aneurysms can include the origins of 1 or both M2 branches and may benefit from a revascularization strategy.2,3 A novel 3-vessel anastomosis technique combining side-to-side and end-to-side anastomoses, allowing for bihemispheric anterior cerebral artery revascularization, was recently reported.4  This 2-dimensional operative video presents the case of a 73-yr-old woman who presented as a Hunt-Hess grade 4 subarachnoid hemorrhage due to the rupture of a large right MCA bifurcation aneurysm. The aneurysm incorporated the origins of the frontal and temporal M2 branches and was deemed unfavorable for endovascular treatment. A strategy using a high-flow bypass from the external carotid artery to the MCA with a saphenous vein (SV) graft was planned to revascularize both M2 branches simultaneously, followed by clip-trapping of the aneurysm. Intraoperatively, the back walls of both M2 segments distal to the aneurysm were connected with a standard running suture, and the SV graft was then attached to the side-to-side construct in an end-to-side fashion. Catheter angiograms on postoperative days 1 and 6 demonstrated sustained patency of the anastomosis and good filling through the bypass. The patient's clinical course was complicated by vasospasm-related right MCA territory strokes, resulting in left-sided weakness, which significantly improved upon 3-mo follow-up with no new ischemia.  The patient consented for inclusion in a prospective Institutional Review Board (IRB)-approved database from which this IRB-approved retrospective report was created.

Cerebral Protection with a Temporary Ascending Aorta–External Carotid Artery Bypass during Common Carotid Artery Revascularization

2018 ◽  
Vol 46 ◽  
pp. 368.e13-368.e17
Author(s):  
Murat Ugurlucan ◽  
Yilmaz Onal ◽  
Didem Melis Oztas ◽  
Cagla Canbay ◽  
Ibrahim Demir ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Artery Bypass ◽  
External Carotid Artery ◽  
Ascending Aorta ◽  
Cerebral Protection ◽  
External Carotid

scholarly journals Hybrid minimally invasive multivessel coronary artery bypass grafting to achieve complete myocardial revascularisation: the first clinical case

2020 ◽  
Vol 24 (3S) ◽  
pp. 108
Author(s):  
I. F. Shabaev ◽  
K. A. Kozyrin ◽  
R. S. Tarasov
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Conflict Of Interest ◽  
Graft Failure ◽  
Clinical Case ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Myocardial Revascularisation

<p><strong>Aim</strong>. To report the first clinical case of the hybrid procedure combining off-pump minimally invasive multivessel coronary artery bypass grafting (MICS-CABG) and percutaneous coronary intervention (PCI) of the obtuse marginal (OM) artery to achieve complete myocardial revascularisation.</p><p><strong>Clinical case</strong>. Bilateral in situ skeletonised left internal mammary artery (IMA) grafting to the left anterior descending artery was performed, and a Y-shape anastomosis was created from the left IMA-right IMA to the circumflex branch. At 2 hours postoperatively, graft failure caused by subtotal stenosis at the graft was diagnosed. Reconstruction of the anastomosis improved the transit time flow measurement by 3.5 hours postoperatively. Acute myocardial infarction did not develop. On postoperative day 1, graft patency was assessed, and then the OM stent was placed. On postoperative day 8, the patient was discharged and referred to the outpatient centre for further treatment and rehabilitation. Hybrid revascularisation offers the advantages of both CABG and PCI; however, the technical complexity is a major limitation for its widespread use. This case reports the development of adverse events during the surgeon's training to perform this nonstandard technology. Timely diagnosis of the initial graft failure and surgical revision led to a successful and complication-free outcome and avoided prolonged patient rehabilitation.</p><p><strong>Conclusion</strong>. Hybrid revascularisation combining MICS-CABG and PCI with new-generation drug-eluting stents can be a worthwhile alternative to conventional multivessel CABG with minimal invasiveness and complete revascularisation.</p><p>Received 5 June 2020. Revised 10 September 2020. Accepted 15 September 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

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