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Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature.

Publication ,  Journal Article
Britz, GW; Agarwal, V; Mihlon, F; Ramanathan, D; Agrawal, A; Nimjee, SM; Kaylie, D
Published in: World Neurosurg
January 2016

BACKGROUND: Vertebrobasilar insufficiency resulting from embolism, atherosclerosis, or arterial dissection has long been a challenge for successful management and outcomes. The main treatment options include medical therapy, angioplasty and stenting, and surgical revascularization. Unlike cardiac or peripheral vascular revascularization, large randomized trials with cerebrorevascularization have not revealed favorable outcomes. In patients who have failed maximal medical therapy, and having persistent debilitating symptomology, cerebral revascularization may still be a viable option. METHODS: We report 3 patients who presented with symptoms of vertebrobasilar ischemia. The diagnosis was verified by computerized tomographic arteriography and digital subtraction angiography. RESULTS: These patients subsequently underwent revascularization with a radial artery graft. We also present a comprehensive review of the literature of treatment for vertebrobasilar insufficiency. CONCLUSIONS: Surgical revascularization should be considered in the posterior circulation in the rare subset of patients with VBI, who remain symptomatic despite having a protracted course of maximal medical therapy with large- and medium-sized vessel occlusions and poor collateral circulation.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

January 2016

Volume

85

Start / End Page

106 / 113

Location

United States

Related Subject Headings

  • Vertebrobasilar Insufficiency
  • Tomography, X-Ray Computed
  • Postoperative Complications
  • Neurologic Examination
  • Middle Aged
  • Male
  • Imaging, Three-Dimensional
  • Humans
  • Female
  • Diffusion Magnetic Resonance Imaging
 

Citation

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Britz, G. W., Agarwal, V., Mihlon, F., Ramanathan, D., Agrawal, A., Nimjee, S. M., & Kaylie, D. (2016). Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature. World Neurosurg, 85, 106–113. https://doi.org/10.1016/j.wneu.2015.08.004
Britz, Gavin W., Vijay Agarwal, Frank Mihlon, Dinesh Ramanathan, Abhishek Agrawal, Shahid M. Nimjee, and David Kaylie. “Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature.World Neurosurg 85 (January 2016): 106–13. https://doi.org/10.1016/j.wneu.2015.08.004.
Britz GW, Agarwal V, Mihlon F, Ramanathan D, Agrawal A, Nimjee SM, et al. Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature. World Neurosurg. 2016 Jan;85:106–13.
Britz, Gavin W., et al. “Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature.World Neurosurg, vol. 85, Jan. 2016, pp. 106–13. Pubmed, doi:10.1016/j.wneu.2015.08.004.
Britz GW, Agarwal V, Mihlon F, Ramanathan D, Agrawal A, Nimjee SM, Kaylie D. Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature. World Neurosurg. 2016 Jan;85:106–113.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

January 2016

Volume

85

Start / End Page

106 / 113

Location

United States

Related Subject Headings

  • Vertebrobasilar Insufficiency
  • Tomography, X-Ray Computed
  • Postoperative Complications
  • Neurologic Examination
  • Middle Aged
  • Male
  • Imaging, Three-Dimensional
  • Humans
  • Female
  • Diffusion Magnetic Resonance Imaging