[Carotid endarterectomy in vertebrobasilar insufficiency]

In 45 patients with uni- or bilateral stenoses of the internal carotid artery in association with symptomatic vertebro-basilar occlusive disease 61 carotid endarterectomies had been performed. 28 patients had at least one patent posterior communicating artery (PCA) visualized angiographically (group A). Of these, 26 patients (93%) became asymptomatic or improved postoperatively. Of the 17 other patients in whom the PCA did not visualize by preoperative angiography, only 8 (47%) subsequently became asymptomatic or were improved (p less than 0.05). Thus, identification of the PCA (angiographically or by transcranial Dopplersonography) is important in predicting those patients in whom carotid endarterectomy may be strongly recommended.