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- W4248045199 abstract "Flow-limiting lesions or embolic phenomena can both produce vertebrobasilar ischemia. This study aims to differentiate the pathophysiology of vertebral ischemia and examine contemporary outcomes of distal vertebral reconstruction. Thirty-seven consecutive distal vertebral artery (VA) reconstructions were performed in 34 patients between February 2005 and November 2011, including bypass to the third portion of the VA (V3) at the C1-2 level (n = 24) or the C0-1 level (n = 4); transposition of the external carotid artery or its occipital branch onto V3 (n = 6); transposition of V3 onto the internal carotid artery (n = 3); and bypass from the ipsilateral subclavian artery to V3 (n = 1). Five patients required a concomitant carotid intervention, and three patients required a partial resection of the C1 transverse process. Symptoms, present in 94% of patients, were attributed to a flow-limiting lesion in 75% (n = 24) and to embolization in the remaining 25% (n = 8). Intraoperatively, five patients required graft revision or conversion of a transposition to a bypass and two patients required vertebral ligation. Median blood loss was 238 mL. Hospital length of stay averaged 2 days. Postoperatively, one patient required re-exploration for bleeding (2.7%), and one patient suffered stroke (2.7%). Two patients had cranial nerve injury (5.4%). There was no perioperative mortality. After a mean follow-up of 28 months, 91% of patients experienced symptom improvement. Of the 28 patients who underwent follow-up imaging, cumulative primary patency was 83%, cumulative primary-assisted patency was 93%, and cumulative secondary patency was 97% (Fig). There were two late deaths of unknown etiology and no late strokes identified. Distal VA reconstruction for flow-limiting or embolic lesions provides excellent long-term patency and stroke protection." @default.
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- W4248045199 date "2012-10-01" @default.
- W4248045199 modified "2023-09-30" @default.
- W4248045199 title "Contemporary Outcomes After Distal Vertebral Reconstruction" @default.
- W4248045199 doi "https://doi.org/10.1016/j.jvs.2012.08.003" @default.
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