Surgical management of vertebral-basilar insufficiency

The authors report treatment of 251 lesions of the major branches of the aortic arch and the vertebral artery in 172 patients. A detailed account is given of the lesions observed (34 lesions of the innominate artery, 93 of the subclavian artery and 119 of the vertebral arteries), the technics used and the indications for surgery. Use of the cervical approach seems to be justified in order to adapt the extent of surgery to the patient's condition. This accounts for the low mortality rate of 1.5%.