Surgical Treatment for Patients with Bilateral Occlusive Vertebral Artery Lesions

Abstract

We evaluated the surgical and long-term follow-up results of VA-CCA transposition in patients with bilateral VA occlusive lesions. Indications for this operation are: 1) symptomatic patients with the infarction in the cerebellum, brain stem or occipital lobe, 2) symptomatic patients with more than 50% VA stenosis with contralateral VA occlusion, 3) symptomatic patients with more than 75% bilateral VA stenosis at origin. In 13 patients, there were no deaths and no major complications. During the follow-up period, 1 patient died of a cardiac event, and another patient had a reattack due to the restenosis of VA stenosis. Another 11 patients showed no reattacks and good patency of VA.
Although there have been no prospective randomized studies for this disease, VA-CCA transposition is a safe and useful treatment for patients with bilateral VA origin occlusive lesions.