Revascularization of the extracranial vertebral artery at any level without cross-clamping

1985 ◽  
Vol 62 (3) ◽  
pp. 334-339 ◽  
Author(s):  
Howard J. Senter ◽  
Sami M. Bittar ◽  
Edwin T. Long
Keyword(s):  
Vertebral Artery ◽  
Foramen Magnum ◽  
Content Type ◽  
Extracranial Vertebral Artery ◽  
Intraluminal Shunt ◽  
A New Technique ◽  
Vertebral Artery Reconstruction ◽  
Artery Reconstruction ◽  
Initial Results ◽  
Fine Print

✓ Hemodynamic insufficiency resulting from extracranial vertebral artery stenosis or occlusion is believed to be the major cause of vertebrobasilar transient ischemic attacks. The major difficulties in treating this disorder have been exposure of the vertebral artery distal to the stenosis and the risk of vertebral artery cross-clamping for vein grafting or carotid artery transposition. The authors describe a new technique for vertebral artery reconstruction at any level by the use of an intraluminal shunt, thus avoiding the necessity to cross-clamp the artery. This procedure was successfully performed at all three levels of the extracranial vertebral artery: C7-4, C3-1, and C-1 to the foramen magnum. The technique of exposure of the vertebral artery at these three levels and the method of vein grafting without cross-clamping are described. The initial results of the procedure are presented.

Saphenous vein graft to the distal vertebral artery between C-1 and C-2 using a lateral-anterior approach

1992 ◽  
Vol 77 (5) ◽  
pp. 812-815 ◽  
Author(s):  
Susumu Miyamoto ◽  
Haruhiko Kikuchi ◽  
Izumi Nagata ◽  
Yoshinori Akiyama ◽  
Kenjiro Itoh ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Bypass Graft ◽  
Content Type ◽  
Vein Bypass ◽  
Extracranial Vertebral Artery ◽  
Vertebral Artery Reconstruction ◽  
Artery Reconstruction ◽  
Saphenous Vein Bypass Graft

✓ The authors present a modified surgical procedure for extracranial vertebral artery reconstruction. The use of the proposed technique results in access to the V3 segment of the vertebral artery between the C-1 and C-2 vertebrae through the retrojugular space without requiring bone rongeuring. A saphenous vein bypass graft was placed between the common carotid artery and the V3 segment of the vertebral artery in three patients with bilateral occlusive lesions of the proximal vertebral arteries.

Pseudoaneurysm of the extracranial vertebral artery

1987 ◽  
Vol 67 (6) ◽  
pp. 935-939 ◽  
Author(s):  
Karl Detwiler ◽  
John C. Godersky ◽  
Lindell Gentry
Keyword(s):  
Soft Tissue ◽  
Vertebral Artery ◽  
Intracranial Aneurysms ◽  
Balloon Occlusion ◽  
Artery Pseudoaneurysm ◽  
Content Type ◽  
Unusual Association ◽  
Associated Symptoms ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ The unusual association of a giant extracranial vertebral artery pseudoaneurysm, intracranial aneurysms, and extracranial carotid occlusion in a woman with neurofibromatosis is presented. Pain as a result of expansion of the mass in the soft tissue of the neck led to her seeking evaluation. Herniation of the mass intraspinally between the occiput and C-1 resulted in myelopathy. Following balloon occlusion of the vertebral artery, the mass and associated symptoms resolved without the need for direct resection. The salient features of these unusually associated problems are discussed.

Hemodynamic analysis of associated extracranial atraumatic vertebral artery aneurysm and arteriovenous fistula

1987 ◽  
Vol 67 (6) ◽  
pp. 940-943 ◽  
Author(s):  
Bruce Rosenblum ◽  
Stephanie Rifkinson-Mann ◽  
Michael Sacher ◽  
Rosemaria Gennuso ◽  
Allen Rothman
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Artery Aneurysm ◽  
Content Type ◽  
Av Fistula ◽  
Extracranial Vertebral Artery ◽  
Fine Print

✓ A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution. Seven cases of extracranial vertebral AV fistulae associated with ipsilateral vertebral artery aneurysms (four traumatic and three as part of vascular dysplastic syndromes) have been reported previously.

Microvascular anatomy of foramen caecum medullae oblongatae

1991 ◽  
Vol 75 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Asim Mahmood ◽  
Manuel Dujovny ◽  
Maximo Torche ◽  
Ljubisa Dragovic ◽  
James I. Ausman
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Foramen Magnum ◽  
Left Vertebral Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Outer Diameter ◽  
Vertebrobasilar Insufficiency ◽  
High Concentration ◽  
Content Type ◽  
Fine Print

✓ The foramen caecum (FC) is a triangular-shaped fossa situated in the midline on the base of the brain stem, at the pontomedullary junction. Although this area is known to have a very high concentration of brainstem perforating vessels, its microvascular anatomy has not been studied in detail. The purpose of this study was to detail the microvasculature of this territory. Twenty unfixed brains were injected with silicone rubber solution and dissected under a microscope equipped with a camera. The origin, course, outer diameter, and branching pattern of the perforators were examined. The total number of perforators found in the 20 brains was 287, with an average (± standard deviation) of 14.35 ± 1.24 perforators per brain (range seven to 28). Their origin was as follows: right vertebral artery in 52 perforators (18.11%); left vertebral artery in 35 (12.19%); basilar artery below the anterior inferior cerebellar artery (AICA) in 139 (48.43%); basilar artery above the AICA in 46 (16.02%); AICA in 10 (3.48%); and anterior spinal artery in five (1.74%). Most of the perforators arose as sub-branches of larger trunks; their average outer diameter was 0.16 ± 0.006 mm while that of trunks was 0.35 ± 0.02 mm. These anatomical data are important for those wishing 1) to study the pathophysiology of vascular insults to this area caused by atheromas, thrombi, and emboli; 2) to plan vertebrobasilar aneurysm surgery; 3) to plan surgery for vertebrobasilar insufficiency; and 4) to study foramen magnum neoplasms.

An angiographic study of meningiomas of the posterior fossa

1971 ◽  
Vol 35 (6) ◽  
pp. 731-741 ◽  
Author(s):  
Georges M. Salamon ◽  
André Combalbert ◽  
Charles Raybaud ◽  
Jorge Gonzalez
Keyword(s):  
Vertebral Artery ◽  
Posterior Fossa ◽  
Foramen Magnum ◽  
Posterior Cranial Fossa ◽  
Occipital Artery ◽  
Angiographic Study ◽  
Content Type ◽  
Meningeal Arteries ◽  
Cranial Fossa ◽  
Fine Print

✓ The meningeal vasculature of the posterior cranial fossa was studied on injected normal anatomical specimens and in angiograms of patients with posterior fossa meningiomas. The correlated results indicate that the dura anterior to the foramen magnum is supplied by meningeal vessels from the carotid siphon, the ascending pharyngeal and middle meningeal arteries. The dura posterior to the foramen magnum is supplied primarily by the occipital artery and secondarily by the vertebral artery.

Persistent proatlantal artery with carotid-vertebral anastomosis

1975 ◽  
Vol 43 (4) ◽  
pp. 499-501 ◽  
Author(s):  
T. Surya Rao ◽  
Prahlad K. Sethi
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Foramen Magnum ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Proatlantal Artery ◽  
Fine Print

✓ The authors describe the occurrence of proatlantal artery as an incidental angiographic observation in a young Indian soldier. This primitive anastomotic channel is seen extending from near the origin of the external carotid artery to the suboccipital region, traversing the foramen magnum and coursing beyond like a vertebral artery. The developmental and roentgenological aspects of carotid-basilar and carotid-vertebral anastomosis are discussed, along with a review of four similar cases reported previously.

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.

En bloc petrosectomy using a Gigli saw for petroclival lesions

1995 ◽  
Vol 83 (3) ◽  
pp. 559-560 ◽  
Author(s):  
Tomio Sasaki ◽  
Makoto Taniguchi ◽  
Ichiro Suzuki ◽  
Takaaki Kirino
Keyword(s):  
Facial Nerve ◽  
Semicircular Canals ◽  
Petrous Bone ◽  
New Technique ◽  
En Bloc ◽  
Content Type ◽  
A New Technique ◽  
Transtentorial Approach ◽  
Fine Print

✓ The authors report a new technique for en bloc petrosectomy using a Gigli saw as an alternative to drilling the petrous bone in the combined supra- and infratentorial approach or the transpetrosal—transtentorial approach. It is simple and easy and avoids postoperative cosmetic deformity. This technique has been performed in 11 petroclival lesions without injuring the semicircular canals, the cochlea, or the facial nerve.

Traumatic arteriovenous fistula of the vertebral artery with spinal cord symptoms

1977 ◽  
Vol 46 (5) ◽  
pp. 681-687 ◽  
Author(s):  
Chikao Nagashima ◽  
Takashi Iwasaki ◽  
Seiichi Kawanuma ◽  
Arata Sakaguchi ◽  
Akira Kamisasa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Rapid Improvement ◽  
Direct Closure ◽  
Content Type ◽  
Vertebral Arteriovenous Fistula ◽  
Fine Print

✓ The authors report a case of a traumatic vertebral arteriovenous fistula with spinal cord symptoms. Direct closure of the fistula was followed by rapid improvement.

Transluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries

1993 ◽  
Vol 78 (2) ◽  
pp. 192-198 ◽  
Author(s):  
Randall T. Higashida ◽  
Fong Y. Tsai ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Tony Smith ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Cerebral Circulation ◽  
Transluminal Angioplasty ◽  
Content Type ◽  
Atherosclerotic Stenosis ◽  
Basilar Arteries ◽  
Posterior Cerebral Circulation ◽  
Fine Print

✓ Transluminal angioplasty for hemodynamically significant stenosis (> 70%) involving the posterior cerebral circulation is now being performed by the authors in selected cases. A total of 42 lesions affecting the vertebral or basilar artery have been successfully treated by percutaneous transluminal angioplasty techniques in 41 patients. The lesions involved the proximal vertebral artery in 34 cases, the distal vertebral artery in five, and the basilar artery in three. Patients were examined clinically at 1 to 3 and 6 to 12 months after angioplasty. Three (7.1%) permanent complications occurred, consisting of stroke in two cases and vessel rupture in one. There were four (9.5%) transient complications (< 30 minutes): two cases of vessel spasm and two of cerebral ischemia. Clinical follow-up examination demonstrated improvement of symptoms in 39 cases (92.9%). Radiographic follow-up studies demonstrated three cases (7.1 %) of restenosis involving the proximal vertebral artery; two were treated by repeat angioplasty without complication, and the third is being followed clinically while the patient remains asymptomatic. In patients with significant atherosclerotic stenosis involving the vertebral or basilar artery territories, transluminal angioplasty may be of significant benefit in alleviating symptoms and improving blood flow to the posterior cerebral circulation.

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