Vertebral artery bypass
R. Berguer, L. V. Andaya and R. B. Bauer
The origin of the vertebral artery is a frequent site for the development
of stenosing lesions. The flow deficit caused by the stenosis of one
vertebral artery is normally compensated for by intracranial anastomosis
between the carotid and basilar arteries or by the opposite vertebral
artery. A number of patients, however, have inadequate intracranial
anastomosis and hypoplasia or stenosis of the opposite vertebral artery,
and symptoms of brain ischemia develop. We describe here four cases in
which a new technique, a subclavian vertebral artery autogenous vein bypass
graft, was used to deal with the diseased segment of the vertebral artery.
Transient postoperative problems included lymphocele and Horner syndrome.
All four bypasses were patent at the time of angiography one week
postoperatively. All four patients were relieved of symptoms of
vertebrobasilar insufficiency.
