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An Evaluation Over Ten Years

David Rosenthal, MD; David Cossman, MD; C. Bruce Ledig, MD; Allan D. Callow, MD

Arch Surg. 1978;113(11):1361-1364.

Abstract
• A review was performed of 114 patients with symptoms of vertebrobasilar insufficiency (VBI) alone, or in combination with carotid territory transient ischemic attacks or carotid territory completed stroke (cCS) with follow-up extending to ten years. The most frequent symptoms of VBI were visual changes (50%), dizziness (31%), and syncope (30%). Patients with symptoms of VBI and arteriographic evidence of intracranial disease, regardless of stump pressure, are at high risk for cerebral ischemia during endarterectomy. At late follow-up, ranging from one to ten years, 63% of the patients were alive; 88% were asymptomatic. Causes of death were mainly cardiac (44%)and stroke (36%), but patients with symptoms of VBI and cCS died earlier and from a second cerebrovascular accident. When a correct preoperative diagnosis was established, carotid endarterectomy produced relief of symptoms in 90% of the patients.

(Arch Surg 113:1361-1364, 1978)

Author Affiliations
From the Vascular Service, Department of Surgery, Tufts-New England Medical Center, and the Department of Surgery, Tufts University School of Medicine, Boston.

Footnotes
Accepted for publication July 28, 1978.

Presented at the 26th scientific meeting of the International Cardiovascular Society, Los Angeles, June 24, 1978.

Reprint requests to Department of Surgery, Tufts-New England Medical Center, 171 Harrison Ave, Boston, MA 02111 (Dr Callow).

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