A narrative review of techniques for surgical revascularization of the extracranial vertebral artery in vertebrobasilar insufficiency

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2023-11-23 DOI:10.1016/j.neuchi.2023.101516

Laura Stone McGuire, Fady T. Charbel

引用次数: 0

Abstract

Vertebrobasilar insufficiency is a condition characterized by poor blood flow through the posterior circulation of the brain, which supplies the brainstem, thalamus, hippocampus, cerebellum, occipital lobes, and medial temporal lobes. Narrowing or occlusion of the vertebral arteries may be result in a range of neurological symptoms, including dizziness, imbalance, dysarthria, and even stroke. If symptomatic patients fail medical management, revascularization of the vertebral artery should be considered. Restoration of blood flow may involve transluminal balloon angioplasty or stent placement; however, certain cases may still require surgical intervention. The complexity of surgical revascularization of the vertebral artery requires careful consideration of skull base and neck anatomy. This review article will focus on bypass of the vertebral artery in the setting of ischemic pathology, describing the technique, anatomical nuances, steps involved in preoperative planning, and postoperative management.

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椎基底动脉功能不全的颅外椎动脉外科血运重建技术综述。

椎基底动脉功能不全是一种以脑干、丘脑、海马、小脑、枕叶和内侧颞叶的后循环供血不足为特征的疾病。椎动脉狭窄或闭塞可导致一系列神经系统症状，包括头晕、失衡、构音障碍，甚至中风。如果有症状的患者治疗失败，应考虑椎动脉血运重建。血流的恢复可能涉及腔内球囊血管成形术或支架置入;然而，某些病例可能仍需要手术干预。椎动脉外科血运重建的复杂性需要仔细考虑颅底和颈部解剖。这篇综述文章将聚焦于缺血病理背景下的椎动脉搭桥术，描述技术、解剖上的细微差别、术前计划和术后处理的步骤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.