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Disabling segmental occlusion of the vertebral artery surgical treatment using a venous bypass from the external carotid to the c 1 c 2 portion of the vertebral artery 2 cases

Disabling segmental occlusion of the vertebral artery surgical treatment using a venous bypass from the external carotid to the c 1 c 2 portion of the vertebral artery 2 cases

Neurochirurgie 27(1): 59-64

The cases of 2 patients who were severely disabled due to signs and symptoms of vertebrobasilar insufficiency caused by unilateral segmental occlusion of 1 vertebral artery are reported. The patency of the occluded vertebral artery beyond C3 was demonstrated by a faint angiographic injection through anastomic ascending cervical arteries which provided insufficient blood supply. The opposite vertebral artery was abnormal in both cases: a proximal kinking with intracranial atheromatous stenosis in the 1st and an atheromatous ostial stenosis in the 2nd one. A venous bypass from the external carotid artery (end to end anastomosis) to the C1-C2 portion of the vertebral artery (end to side anastomosis) was performed. Postoperatively the signs and symptoms disappeared immediately. The stability of this result is shown by a follow up period of 13 mo. in the 1st case and 9 mo. in the 2nd one. A control angiogram demonstrated a good supply to the vertebro-basilar system through the bypass, the excellent permeability of which was further confirmed by repeated Doppler ultrasound examinations. The indication of this technique is discussed.

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Accession: 005166994

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PMID: 7254454

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