title: Treatment of proximal vertebral artery disease.
abstract: Vertebral arterial disease (VAD) is a less commonly recognized and treated source of cerebrovascular ischemia compared with carotid artery disease. Patients are often referred for treatment after they have developed symptoms in the form of transient ischemic attacks or had a posterior hemispheric stroke. Traditional treatment of VAD has been surgical. More recently, endovascular treatment of VAD has been utilized. We performed a retrospective review of our institutional experience in treating VAD from 2001 to 2010. For treatment of proximal VAD, perioperative morbidity is lower for the endovascular group than for the surgical group, but six-week mortality was higher for the endovascular group. Complete resolution of symptoms occurred more frequently with surgery than with endovascular therapy. Therefore surgical reconstruction appears to be preferable to angioplasty and stenting for treatment of proximal vertebral artery occlusive disease.
authors.affiliation: Division of Vascular Surgery, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: William
authors.initials: W
authors.lastname: Shutze
authors.forename: Joshua
authors.initials: J
authors.lastname: Gierman
authors.forename: Karen
authors.initials: K
authors.lastname: McQuade
authors.forename: Gregory
authors.initials: G
authors.lastname: Pearl
authors.forename: Bertram
authors.initials: B
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*
keywords: Vertebral; arterty; endovascular; surgical; treatment