• World Neurosurg · Jul 2012

    Case Reports

    Staged surgical treatment for symptomatic vertebrobasilar artery stenosis: combined treatment with endovascular angioplasty and bypass surgery.

    • Takahiro Ota, Kenichi Usami, Akira Iijima, and Nobuhito Saito.
    • Department of Neurosurgery, University of Tokyo, Tokyo, Japan. toota-tky@umin.ac.jp
    • World Neurosurg. 2012 Jul 1;78(1-2):90-4.

    ObjectiveBecause the early risk of stroke recurrence in patients with posterior circulation infarctions is high, patients with vertebrobasilar events require active preventive treatment. Previous reports have described the use of balloon angioplasty and stenting or surgical revascularization to the vertebrobasilar artery area. To compensate for the disadvantages of these techniques, we combined endovascular and surgical treatments in a patient with symptomatic vertebrobasilar artery stenosis.MethodsAfter endovascular surgery, we continued medical therapy to stabilize the blood flow in the posterior circulation. Superficial temporal artery-superior cerebellar artery bypass was planned for the chronic stage (∼1-2 months).ResultsThree cases (2 vertebral artery stenosis, 1 basilar artery stenosis) presented with recurrent transient ischemic attacks or deteriorating symptoms under intensive medical treatment. We conducted staged therapy using balloon angioplasty followed by superficial temporal artery-superior cerebellar artery bypass. All patients were symptom-free after treatment with the combined therapy.ConclusionsOur staged therapy may be an effective treatment for symptomatic vertebrobasilar artery stenosis.Copyright © 2012 Elsevier Inc. All rights reserved.

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