[Simultaneous one- or two-stage restoration of the vertebral and carotid arteries]

Surgery of the vertebral artery is controversial. Few teams performed this procedure routinely. The usefulness of the vertebral artery surgery is even more questionable when carotid artery lesions are associated. In such cases many surgeons claim that carotid artery surgery alone can relieve symptoms of vertebrobasilar insufficiency. In deciding whether or not to perform vertebral artery surgery three questions are essential. First, is a restauration of one or both vertebral artery necessary in this situation? Second, will combined surgery increase the risk of mortality and morbidity? Third what technique should be used and in what order?