By Bernard George M.D., Claude Laurian M.D. (auth.)
Our universal curiosity in surgical procedure of the vertebral artery was once born in 1976, while as citizens within the similar health facility, we attended an try out through senior surgeons to regard an aneurysm of the vertebral artery on the C three point. lengthy discussions had preceded this unsuccessful trial, to make your mind up if surgical procedure used to be indicated and to decide on the surgical course. ultimately an instantaneous lateral method was once played, yet entry used to be tough and proper remedy was once very unlikely, leading to simply partial aid of the aneurysmal pouch. Following this adventure, we determined to hunt a typical and good outlined procedure for exposition of the vertebral artery. assessment of the literature indicated a few surgical makes an attempt, however the descriptions didn't supply the influence of defense and reproducibility. No landmark at the defined surgical path seemed sufficiently trustworthy. Henry's anatomical paintings (1917) gave the single actual description on vertebral artery anatomy, and it grew to become the foundation for our paintings. whilst an identical sufferer was once referred back three hundred and sixty five days later, after a brand new stroke within the vertebro-basilar process, we had at the back of us repetitive adventure on cadavers of an unique method of the distal vertebral artery.
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Our universal curiosity in surgical procedure of the vertebral artery used to be born in 1976, while as citizens within the comparable sanatorium, we attended an try by way of senior surgeons to regard an aneurysm of the vertebral artery on the C three point. lengthy discussions had preceded this unsuccessful trial, to determine if surgical procedure used to be indicated and to settle on the surgical direction.
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Extra info for The Vertebral Artery: Pathology and Surgery
Hemorrhage in the plaque was observed by Hutchinson and Yates (1957) and Duffy and Jacobs (1958), but ulceration of V. A. plaques is much less frequent than on the carotid artery and was estimated at 4 % by Fisher et al. (1965). On an autopsy series, Laurian (1977) studied the morphologic aspects of atherosclerotic lesions at the subclavian V. A. junction. Three different aspects were demonstrated (Figs. 12 and 13). - The most frequent is a diaphragm stenosis at the ostium, resulting in fact from subclavian artery arteritis proliferation.
Following penetrating trauma, detachable balloon is certainly the most appropriate. The aim of treatment by endovascular methods should be the same as that of surgery. A. V. F. closure with preservation of V. A. flow. However, this goal cannot always be reached, since it is sometimes impossible to pass the balloon across the fistula or to stabilize it at the proper level. 2 Traumatic Arteriovenous Fistulas These difficulties are particularly encountered in the following settings: - Large fistula with false aneurysm.
D. preferentially affects young and middle-aged patients, mainly female (Mettinger and Ericson, 1982). 3 Clinical Findings Among clinical findings, cerebral ischemia is not the predominant feature, even in cases involving the cervicocephalic vessels. In their compilation from the literature, Mettinger and Ericson (1982) found that more than 50% had hemorrhagic neurological events. Symptoms of vertebrobasilar insufficiency were rarely reported. 4 Angiographic Features 1. The characteristic angiographic feature of F.
The Vertebral Artery: Pathology and Surgery by Bernard George M.D., Claude Laurian M.D. (auth.)