[Diagnosis and therapy of cerebrovascular insufficiency]

In these days supra-aortic occlusions can be easily diagnosed with noninvasive methods like Doppler-sonography and Duplex B-Scan. Further Diagnosis must include an intravenous or intraarterial DSA and a computer-assisted tomogram. The indication of operation depends on the stage of carotid insufficiency. Priority is given to the reconstruction in stage II of the transitory ischaemic attack. In 2.5 years far more than 2,000 vascular reconstructions of the supraaortic branches have been performed in the Department of Vascular Surgery at the General Hospital in Nuremberg. Morbidity and mortality of this operation were less than 1%. Carotid reconstruction can thus be performed even in elder patients at minimum risk--if done in a special hospital.