Results of carotid endarterectomy for vertebrobasilar insufficiency: an evaluation over ten years.
A review was performed of 114 patients with symptoms of vertebrobasilar insufficiency (VBI) alone, or in combination with carotid territory transient ischemic attacks or carotid territory completed stroke (cCS) with follow-up extending to ten years. The most frequent symptoms of VBI were visual changes (50%), dizziness (31%), and syncope (30%). Patients with symptoms of VBI and arteriographic evidence of intracranial disease, regardless of stump pressure, are at high risk for cerebral ischemia during endarterectomy. At late follow-up, ranging from one to ten years, 63% of the patients were alive; 88% were asymptomatic. Causes of death were mainly cardiac (44%) and stroke (36%), but patients with symptoms of VBI and cCS died earlier and from a second cerebrovascular accident. When a correct preoperative diagnosis was established, carotid endarterectomy produced relief of symptoms in 90% of the patients.
D000328:Adult; D000368:Aged; D001488:Basilar Artery; D002339:Carotid Arteries / Q000601:surgery*; D002544:Cerebral Infarction / Q000517:prevention & control; D002561:Cerebrovascular Disorders / Q000601:surgery*; D004691:Endarterectomy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014711:Vertebral Artery