Ten males and one female with symptoms of vertebrobasilar insufficiency associated with vertebral artery stenosis at its origin were surgically treated by reconstruction. Their ages ranged from 46 to 67 years (mean, 59 years). Their symptoms included vertigo, dysarthria, dysphagia, syncope, motor and/or sensory disturbance, and cerebellar ataxia. Six had multiple stenotic lesions. Surgical procedures consisted of eight vertebral artery transpositions to the common carotid artery, two subclavian artery-vertebral artery bypasses with saphenous vein grafting, and one vertebral arterythyrocervical trunk anastomosis. Postoperative angiography showed all reconstructions to be patent. All but three patients had complete resolution of their symptoms, and no neurological deficits occurred as a result of interruption of cerebral flow. Miosis limited to the affected side was observed in nine cases. As has been noted in previous reports concerning arterial reconstruction, vertebral artery to common carotid artery transposition is a safe and relatively easy procedure.
