Abstract
A posterior circulation infarction is caused by a vertebral artery (VA) lesion (stenosis or occlusion). The purpose of this study is to assess early and long-term outcomes after open surgery for a VA lesion at the origin. In a retrospective study conducted from January 1, 2000 through March 31, 2020 in a single center, patients were treated with vertebral artery to carotid artery transposition (VCT). A total of 28 patients, with a mean age of 65.29±9.81years (range 45-84), were screened, including 22 patients with VA stenosis and 6 patients with VA occlusion. The complication rate was 21.4% (n=6), including Horner syndrome (n=2), lymphocele (n=1), respiratory failure (n=1), embolism of a subclavian artery stenosis (n=1), and vocal cord paralysis (n=1). The 30-day mortality rate was 0%. Primary patency was 100%. Overall, improvement in symptoms was 85.7% (n=24) after surgery and 96.4% after 30days. In the long-term results, primary patency was 100%, and the cumulative patency rate after 60months was 85.7%, with 1 occlusion of the VA. Cumulative survival rates were 94%, 87%, 69%, and 59% after 12, 24, 60, and 72months (n=5). One of the 3 patients died after 60months because of VA occlusion and posterior circulation infarction. VCT is a safe, effective, and durable procedure. It provides good stroke protection, symptomatic relief, and perioperative risk at acceptable levels, in experienced hands.
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