Vertebral Artery to Common Carotid Artery Transposition: 2-Dimensional Operative Video.

Abstract

Vertebral artery (V1 segment) transposition is a useful technique in the treatment of patients with either proximal subclavian artery stenosis with vertebral "steal" syndrome or severe vertebral artery origin stenosis. This patient required extracranial augmentation of right vertebral artery blood flow to treat proximal vertebral artery stenosis. This was achieved through a V1 to common carotid artery end-to-side anastomosis. The end-to-side anastomosis was performed with the first stitch after the heel stich placed to the inside of the vessel, and the back wall was run from the inside. The anastomosis was completed by running along the front wall from the external surface of the arteries. The anastomosis was flushed by temporary removal of the proximal carotid artery clamp. The anastomotic suture was then tied, and clamps were removed. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.