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Simultaneous carotid-vertebral reconstruction.

M F McNamara¹, R Berguer

¹Wayne State University, Division of Vascular Surgery, Detroit, Michigan.

The Journal of Cardiovascular Surgery

|March 1, 1989

Summary

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Simultaneous carotid and vertebral artery reconstruction effectively treats vertebrobasilar hypoperfusion. However, distal vertebral bypass combined with external carotid angioplasty is not recommended.

Area of Science:

Vascular Surgery
Cerebrovascular Disease
Atherosclerosis

Background:

Atherosclerotic lesions often affect both carotid and vertebral arteries.
Hypoperfusion due to critical carotid stenosis is a common cause of vertebrobasilar symptoms.

Purpose of the Study:

To evaluate the effectiveness of combined carotid and vertebral artery reconstruction.
To assess outcomes of simultaneous surgical correction of cervical artery disease.

Main Methods:

Retrospective study of 36 patients undergoing combined carotid-vertebral reconstruction between 1982 and 1987.
Procedures included carotid endarterectomy or external carotid angioplasty with vertebral reimplantation or distal bypass.

Main Results:

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Combined procedures effectively relieved vertebrobasilar hypoperfusion symptoms.
26 patients presented with vertebrobasilar symptoms, 10 with critical carotid disease.
Distal vertebral bypass with external carotid angioplasty yielded poor outcomes.

Conclusions:

Combined carotid-vertebral reconstruction is an effective treatment for vertebrobasilar hypoperfusion.
Careful consideration of surgical technique is crucial; distal vertebral bypass should not be combined with external carotid angioplasty.