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[Simultaneous carotid and vertebral revascularization in the aged]
G Illuminati1, F G Caliò, A Bertagni
1IV Clinica Chirurgica, Università degli Studi La Sapienza, Roma.
Minerva Chirurgica
|February 12, 1998
Summary
Combined carotid and vertebral artery surgery effectively treated severe vertebro-basilar insufficiency in elderly patients. Procedures showed no mortality or stroke, with sustained patency and symptom relief.
Area of Science:
- Vascular Surgery
- Neurology
Background:
- Vertebro-basilar insufficiency (VBI) poses significant neurological risks.
- Combined surgical intervention for carotid and vertebral arteries addresses complex cerebrovascular disease.
Purpose of the Study:
- To evaluate the safety and efficacy of combined carotid and vertebral artery revascularization.
- To assess the long-term patency and clinical outcomes of the combined procedure.
Main Methods:
- Retrospective analysis of five patients (mean age 76) undergoing combined revascularization.
- Procedures included vertebral artery transposition or bypass and carotid endarterectomy.
- Postoperative assessment via arteriography, duplex-scan, and clinical follow-up.
Main Results:
- No postoperative mortality or stroke observed.
- Complete symptom relief in 4 out of 5 patients; mild residual vertigo in one.
- All vascular reconstructions remained patent at a mean 11-month follow-up.
Conclusions:
- Combined carotid and vertebral artery surgery is a safe and effective treatment for selected VBI patients.
- The combined approach does not increase surgical risk compared to separate procedures.
- This strategy prevents failure of isolated carotid revascularization for VBI symptoms.