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Vertebrobasilar insufficiency

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https://www.readbyqxmd.com/read/28922887/occipital-artery-to-anterior-inferior-cerebellar-artery-bypass-with-radial-artery-interposition-graft-for-vertebrobasilar-insufficiency-3-dimensional-operative-video
#1
Arnau Benet, Halima Tabani, Jae Seung Bang, Ali Tayebi Meybodi, Michael T Lawton
No abstract text is available yet for this article.
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28902820/the-operative-technique-of-shunting-to-the-third-v3-segment-of-the-vertebral-artery
#2
A N Vachev, O V Dmitriev
The authors provide a detailed description of the step-by-step technique of performing the operation of shunting to the V3 segment of the vertebral artery in patients with clinical manifestations of vertebrobasilar insufficiency (VBI). Reported are surgical outcomes in a total of 57 patients with VBI. Of these, 5 patients underwent arterial bypass grafting and 52 patients endured autovenous shunting. One patient developed shunt thrombosis in the early postoperative period and, unfortunately, died, with the remaining 51 shunts being patent...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28846540/determinants-of-long-term-outcome-in-patients-after-percutaneous-stent-assisted-management-of-symptomatic-subclavian-or-innominate-artery-stenosis-or-occlusion
#3
Tadeusz Przewlocki, Leszek Wrotniak, Anna Kablak-Ziembicka, Piotr Pieniazek, Agnieszka Roslawiecka, Daniel Rzeznik, Marcin Misztal, Wojciech Zajdel, Rafał Badacz, Andrzej Sokolowski, Mariusz Trystula, Piotr Musialek, Krzysztof Zmudka
AIMS: Incidence and determinants of restenosis and adverse events after endovascular management (PTA±stent) of the subclavian/innominate artery (SA/IA) stenosis/occlusion remain unclear due to relatively short-term follow-up or limited size of prior studies. This large-scale, long-term prospective study investigated safety, efficacy, and prognosis after SA/IA PTA±stent. METHODS AND RESULTS: The study involved 411 consecutive patients with symptomatic SA/IA stenosis/occlusion; 393 after successful PTA±stent were followed annually for up to 16 (minimum 1) years...
August 29, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28843759/hybrid-technique-for-the-treatment-of-refractory-vertebrobasilar-insufficiencies
#4
Xia Lu, Yan Ma, Bin Yang, Peng Gao, Yabing Wang, Liqun Jiao
BACKGROUND: Tortuous or occluded vertebral arteries (VAs) can lead to the endovascular treatment of vertebrobasilar insufficiency being impractical. Bypass surgery is optional, but a craniotomy of the posterior fossa is complicated when physiological vessels must be abandoned. We report 3 cases of refractory vertebrobasilar insufficiencies with different situations of unavailable approaches. Patients were treated by different hybrid operation strategies. CASE DESCRIPTION: Case 1 was of right vertebral artery ostium (VAO) severe stenosis with right V1 segment tortuosity and was treated by right VAO transposition, during which the proximal subclavian artery (SubA) was blocked by a balloon guide catheter...
August 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28838901/the-association-between-vertebrobasilar-insufficiency-and-the-risk-of-dementia-a-nationwide-register-based-retrospective-cohort-study-in-taiwan
#5
Fu-Chi Yang, Shao-Yuan Chen, Jiu-Haw Yin, Chun-Chieh Lin, Yueh-Feng Sung, Chung-Hsing Chou, Chi-Hsiang Chung, Wu-Chien Chien, Chia-Kuang Tsai, Chia-Lin Tsai, Guan-Yu Lin, Jiunn-Tay Lee
OBJECTIVES: Neurodegenerative disorders are reportedly characterised by decreased regional cerebral blood flow. However, the association between vertebrobasilar insufficiency (VBI) and dementia remains unclear. In this nationwide, population-based, retrospective cohort study, we explored the potential association between VBI and dementia. DESIGN: Nationwide population-based cohort study. SETTING: Patients with VBI were newly diagnosed between 2000 and 2005 from the Taiwan National Health Insurance Research Database...
August 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28828133/bow-hunter-s-syndrome-in-a-patient-with-vertebral-artery-atresia-an-arcuate-foramen-and-unilateral-deafness-a-case-report
#6
Charles T Simpkin, Kelly E Davis, Brady S Davis, Andrew M Vosko, Michael E Jorgensen
Bow hunter's syndrome (BHS) is a rare cause of vertebrobasilar insufficiency that occurs when the vertebral artery (VA) is occluded on rotation of the head and neck. This dynamic occlusion of the VA can occur anywhere along its course after it arises from the subclavian artery. Although most cases are associated with compression by osteophytes, cervical spondylosis, or lateral disc herniation, BHS has a highly variable clinical course that depends on the patient's specific anatomy. Therefore, it may be important for clinicians to be aware of anatomical variants that predispose individuals to BHS...
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28826714/internal-maxillary-artery-to-upper-posterior-circulation-bypass-using-a-superficial-temporal-artery-graft-surgical-anatomy-and-feasibility-assessment
#7
Ali Tayebi Meybodi, Michael T Lawton, Roberto Rodriguez Rubio, Sonia Yousef, Xiaoming Guo, Xuequan Feng, Arnau Benet
BACKGROUND: Revascularization of the upper posterior circulation (UPC), including the superior cerebellar [SCA] and posterior cerebral arteries [PCA], may be necessary as part of the surgical treatment of complex UPC aneurysms or vertebrobasilar insufficiency. The existing bypass options have relative advantages and disadvantages. However, the use of a superficial temporal artery graft (STAg) in a bypass from the internal maxillary artery (IMA) to the UPC has not been previously assessed...
August 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28680502/pathophysiology-and-diagnosis-of-vertebrobasilar-insufficiency-a-review-of-the-literature
#8
REVIEW
Arlindo Cardoso Lima Neto, Roseli Bittar, Gabriel Scarabotolo Gattas, Edson Bor-Seng-Shu, Marcelo de Lima Oliveira, Rafael da Costa Monsanto, Luis Felipe Bittar
Introduction  Vertebrobasilar insufficiency is defined as transitory ischemia of the vertebrobasilar circulation. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body are the most common symptoms. Objective  To review the literature regarding the three available diagnostic testing in patients with dizziness complaints secondary to vertebrobasilar insufficiency (VBI): magnetic resonance angiography; transcranial Doppler ultrasound; and vertebrobasilar deprivation testing...
July 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28626412/congenital-bilateral-c2-transverse-foramina-stenosis-causing-adult-onset-vertebrobasilar-insufficiency-and-posterior-circulation-stroke
#9
Ajeet Gordhan, Catherine Lockhart
Vertebrobasilar insufficiency leading to posterior circulation infarcts caused by congenital hypoplasia of the bilateral transverse foramina at the C2 level, affecting the caliber and flow of the bilateral distal cervical vertebral arteries in an adult, has not been previously reported. A 41-year-old male presented with episodic dizziness for a period of 1 year prior to consultation. Computed tomography angiography of the head and neck demonstrated congenital hypoplasia of the bilateral C2 transverse foramina, with absence of the vertebral arteries in each of the foramina and collateral reconstitution of diminutive intracranial vertebral artery segments...
May 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28594803/treatment-of-vertebrobasilar-insufficiency-due-to-stenosis-and-aneurysm-of-the-vertebral-artery
#10
O V Dmitriev, A N Vachev, M Iu Stepanov, T Iu Vovk, V V Kutsenko, A V Krugomov, O V Tereshina
A dissecting aneurysm of the vertebral artery in the extracranial portion is a rare pathology. It may either have a symptom-free course or induce a clinical picture of vertebrobasilar insufficiency. To the main methods of surgical treatment belong endovascular techniques and resection of an aneurysm with shunting of the V3 segment of the vertebral artery. Presented in the article is a clinical case report regarding successful surgical management of a dissecting aneurysm of the extracranial portion in a young woman presenting with a clinical course of vertebrobasilar insufficiency and treated by means of ligation of the vertebral artery in the V1 segment and autovenous shunting from the external carotid artery to the V3 segment of the vertebral artery...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28583457/vertebrobasilar-insufficiency-due-to-distal-posterior-inferior-cerebellar-artery-compression-in-chiari-1-5
#11
M Burhan Janjua, Iryna Ivasyk, Jeffrey P Greenfield
BACKGROUND: Chiari malformation is characterized by radiographic evidence of herniation of cerebellar tonsils below the foramen magnum and a symptom complex of headaches; breathing, swallowing, or sleep difficulties; ataxia; restless; and motor and/or sensory deficits. CASE DESCRIPTION: We report a case of a 34-year-old woman whose imaging indicated a Chiari 1.5 with brainstem (caudal medulla) herniation and an expansive cervical syrinx. Her symptom complex showed signs both of cervical syringomyelia, as well as ones localizable to the medulla...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28574040/-use-of-a-filtering-protective-device-during-angioplasty-and-stenting-of-the-brachiocephalic-trunk
#12
V N Tsygankov, A M Frantsevich
The authors carried out a pilot study aimed at assessing the possibility and efficacy of using filtering systems for protection of cerebral arteries from distal embolism during angioplasty and stenting of the brachiocephalic trunk. A total of five patients presenting with lesions of the brachiocephalic trunk underwent 5 roentgenoendovascular interventions with the use of the filtering protective device Spider FX. Angiographic and clinical success was achieved in 100% of cases. Particles of debris were obtained from the protective device in all cases...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28450231/bow-hunter-s-syndrome-surgical-management-video-and-review-of-the-literature
#13
Ben A Strickland, Martin H Pham, Joshua Bakhsheshian, Jonathan J Russin, William J Mack, Frank L Acosta
BACKGROUND: Bow Hunter's syndrome (BHS) is a rare condition characterized by vertebrobasilar insufficiency associated with rotational vertebral artery occlusion during head movement. Many existing reports describe surgical management, although no single technique has proven superior. OBJECTIVE: To review all reported cases of BHS with focus on outcomes of individual techniques as well as to present a video report of a posterior decompression without fusion performed at the authors' institution...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434468/the-effect-of-chinese-herbal-medicine-banxia-baizhu-tianma-decoction-for-the-treatment-of-vertebrobasilar-insufficiency-vertigo-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
ZhenLang Guo, ZhenNing Su, ZhengFei Wang, XiaoMu Luo, RenKui Lai
OBJECTIVES: Banxia Baizhu Tianma Decoction (BBTD) is widely used to treat vertebrobasilar insufficiency vertigo (VBIV) in China, but its efficacy remains largely unexplored. We systemically summarized relevant evidence from randomized controlled trials (RCTs) to assess the therapeutic effect of BBTD. METHODS: Seven electronic databases were searched for relevant electronic studies published before July 2016. We evaluated RCTs that compared BBTD, anti-vertigo drugs and a combination of BBTD and anti-vertigo drugs...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28262395/lateral-and-posterolateral-foraminal-variations-of-the-atlas-a-meta-analysis
#15
Przemysław A Pękala, Brandon Michael Henry, Jakub R Pękala, Karolina Saganiak, Dominik Taterra, Jerzy A Walocha, R Shane Tubbs, Krzysztof A Tomaszewski
The lateral (LF) and posterolateral (PLF) foramina are anatomical variants of the atlas. Both variants have been implicated in multiple neurological conditions including vertebrobasilar insufficiency, with symptoms such as dizziness, syncope, auditory and visual disturbances and paresis. The aim of this study was to conduct a systematic meta-analysis on the prevalence and anatomical characteristics of the LF and PLF. An extensive search of the major electronic databases was conducted to identify all studies that reported relevant data on the LF and PLF...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28117210/cryptic-recanalization-of-chronic-vertebral-artery-occlusion-by-head-rotation
#16
Kenji Yagi, Hiroshi Nakagawa, Hideo Mure, Shinya Okita, Shinji Nagahiro
BACKGROUND: Chronic vertebral artery occlusion (VAO) can be associated with ischemic stroke, as thrombi formed under blood flow stagnation around the stump of the VAO may migrate into the brain. We report a new mechanism of chronic VAO-associated ischemic stroke and a patient with cryptic recanalization of chronic VAO by head rotation. CASE DESCRIPTION: A 74-year-old man presented with chronic right VAO and repeated ischemic embolic stroke in the posterior circulation despite antiplatelet therapy...
April 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28007277/random-finding-of-a-ruptured-kommerell-aneurysm-after%C3%A2-stroke
#17
Iannis Ben Abdallah, Salma El Batti, Pierre Julia, Jean-Marc Alsac
The random finding of a ruptured Kommerell aneurysm (rKA) is exceptional. We report the case of a 74-year-old man who received an incidental diagnosis of a contained rKA involving an aberrant right subclavian artery after a stroke. He underwent successful hybrid repair with the use of thoracic endovascular aortic repair associated with cervical debranching of the left subclavian artery and vascular plug occlusion of both subclavian artery origins. Whereas no early adverse event was reported, the patient experienced a vertebrobasilar insufficiency once he had recovered, requiring an additional right carotid-to-subclavian bypass...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27903481/hybrid-repair-of-complex-left-subclavian-artery-injury-with-partial-transection-and-complete-thrombosis-in-an-unstable-patient-following-blunt-trauma
#18
Ilitch Diaz-Gutierrez, Muhammad A Rana, Barkat Ali, John M Marek, Mark Langsfeld
Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high-speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Patient also had a left main-stem bronchus avulsion along with major intra-abdominal injuries and multiple spine and long bone fractures...
April 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27799374/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#19
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798325/dynact-angiography-for-the-diagnosis-of-bilateral-bow-hunter-s-syndrome
#20
Tony Lu, Ponraj Chinnadurai, Javier E Anaya-Ayala, Orlando M Diaz
We herein present a rare case of bilateral positional vertebrobasilar insufficiency secondary to mechanical obstruction of the V2 segment of the vertebral artery in a 71-year-old patient presenting with vertigo, occipital headache, tremors and respiratory irregularities. Two-dimensional digital subtraction angiography is the traditional diagnostic imaging standard but does not capture any peri-vascular bony or soft tissue abnormalities that are important to understand the three-dimensional pathophysiology. Intra-procedural cone-beam computed tomography (CT) is an increasingly used diagnostic adjunct, available in most modern angiographic suites that allows for the three-dimensional visualization of the vasculature as well as CT-like soft tissue visualization of its surrounding anatomy...
February 2017: Interventional Neuroradiology
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