Cervical vertebral and subclavian artery reconstructions.

Abstract

At our institution, endovascular treatment of subclavian artery (SA) or vertebral artery (VA) occlusive disease has been used as the treatment of first choice during the last years. Open procedures were performed only in cases of failed or unfeasible endovascular treatment or total occlusion of the proximal VA or SA, respectively. Nineteen open procedures were performed between 1992 and 1996. Proximal reconstructions included SA to common carotid artery (CCA) transpositions or bypasses and VA to CCA transpositions. Distal reconstructions included transposition techniques or direct reconstruction in a few cases of traumatic lesions. The operative procedure used two-channel transcranial Doppler monitoring for cases involving simultaneous CCA and SA or VA cross clamping. There was one technical failure of a distal VA reconstruction. No surgical complications occurred. The recent pertinent literature with regard to indications and techniques of SA and VA reconstructions is discussed.