This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Van Schil, P. E. Y. Articles by Schepens, M. A. A. Search for Related Content PubMed Articles by Van Schil, P. E. Y. Articles by Schepens, M. A. A. Social Bookmarking                         What's this?

Long-Term Clinical and Duplex Follow-up After Proximal Vertebral Artery Reconstruction

Departments of Vascular Surgery and Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, the Netherlands

Robert G. A. Ackerstaff

Departments of Vascular Surgery and Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, the Netherlands

Freddy E. E. Vermeulen

Departments of Vascular Surgery and Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, the Netherlands

Bert C. Eikelboom

Departments of Vascular Surgery and Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, the Netherlands

Marc A. A. Schepens

Departments of Vascular Surgery and Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, the Netherlands

From 1977 to 1989, 28 patients, 18 men and 10 women, underwent 29 proximal vertebral artery reconstructions. Indications were vertebrobasilar insufficiency in 17 patients and TIA or stroke in 6. Five were asymptomatic. Procedures performed were endarterectomy in 20, reimplantation in 5, venous bypass in 3, and decompression in 1 case. Concomitant procedures were coronary artery bypass grafting (6) and carotid, subclavian, or innominate artery revascularization (14).

There was no operative mortality. There were 3 early reoperations for occlusion, bleeding, and lymph fistula, respectively.

Except for 1 foreign patient recent clinical follow-up was complete. Mean follow-up was 85.6 months (range 17-146). During follow-up 10 patients died. Causes were mainly cardiac (3), carcinoma (3), and stroke (2). Seventeen patients were alive, 13 had no cerebrovascular symptoms, 2 sustained a hemispherical stroke, 1 was only slightly improved, and 1 had a drop attack 131 months after operation. Five and ten-year actuarial survival rates were 85% and 51% respectively.

Follow-up with duplex scan was available in 26 patients and was complete in 24. Mean duplex follow-up was 78.6 months (range 3-146). Significant abnormalities were noted in 6 but with symptoms in only 1 patient. Mean time to restenosis was 77.3 months. Late angiographic control in 10 patients correlated well with duplex findings.

Proximal vertebral artery reconstruction yields good clinical long-term results, and duplex scan is a useful tool in the follow-up of these patients.

Vascular and Endovascular Surgery, Vol. 28, No. 7, 471-479 (1994)
DOI: 10.1177/153857449402800705


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?