Modern foreign experience of study of vertebral-basilar insufficiency: clinical manifestations and diagnostic challenges.

Shumilina, M.V.; Emets, E.V.

doi:10.24022/1814-6910-2018-15-2-75-82

CPC

2018

DOI: 10.24022/1814-6910-2018-15-2-75-82

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Modern foreign experience of study of vertebral-basilar insufficiency: clinical manifestations and diagnostic challenges.

M.V. Shumilina¹,

E.V. Emets²

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Optimization of Surgical Treatment of Vertebral Artery Tortuosity

Султанов

Gaibov

Nematzoda³

et al. 2020

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Objective: Analysis of the results of standard and optimized surgical treatment of vertebral artery (VA) tortuosity. Methods: The results of surgical treatment of 52 patients with VA tortuosity were analyzed. There were 18 men (34.6%), and 34 women (65.4%). The age of patients ranged from 23 to 75 years. C- and S-shaped kicking of VA occurred in 38 cases, coiling in 8 cases and Powers syndrome in 6 cases. In 28 (53.8%) patients there was also hypoplasia of the contralateral VA, and in 7 (13.5%) cases there was a pathological deformation of the internal carotid artery. Results: Depending on the shape of the tortuosity, 4 techniques of reconstructive operations were performed to eliminate tortuosity. In the postoperative period thrombosis of the anastomosis line noted in 2.8% of cases, TIA – in 1.9%, and stroke – in 1.9%. The immediate and long-term results in the groups showed the effectiveness and best results in the group of patients who underwent lateralization of the VA of the author’s modification. Also established that for VA coiling, the method of choice is to move and implantation of VA into the carotid artery. Conclusions: Correction of VA tortuosity should be differentiated, and the choice of the method of surgery technique should depend on the type of tortuosity and concomitant vascular pathology. The lateral and anterior moving VA ostium helps to reduce the rate of anastomosis thrombosis and greatly facilitates the surgery technique. Keywords: Vertebral artery, tortuosity, kinking, coiling, vertebrobasilar insufficiency, chronic cerebral ischemia, surgical treatment.

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Optimization of Surgical Treatment of Vertebral Artery Tortuosity

Султанов

Gaibov

Nematzoda³

et al. 2020

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The potential of duplex scanning in the diagnosis of pathological tortuosity of the vertebral artery

Yunusov

Султанов

Gaibov

et al. 2021

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Aim. To assess the capabilities of duplex scanning and study the features of hemodynamics in the vertebral arteries before and after surgical treatment.Material and methods. The results of anatomical and circulatory characteristics of an extracranial segment of the vertebral arteries in 52 patients with various forms of pathological tortuosity were analyzed. Kinking was present in 38 patients, coiling in 8 patients, and Powers anomaly in 6 patients. There were 18 men and 34 women. The mean age of the patients was 45.6±8.7 years.Results and discussion. In all types of PT of VA with ostium stenosis, the diameter of the artery was decreased, and based on tortuosity it contributed both to the reduction and deterioration of arterial blood flow to the vertebrobasilar basin. The decrease or increase in the linear velocity of blood flow, as well as other blood flow parameters, depended on both the type of pathological tortuosity of the PA and on the vessel diameter and the value of angulation. Hypoplasia of the opposite vertebral artery also occurred in 28 patients, which resulted in impaired blood supply to the brain.Vascular examination after reconstructive surgeries resulted in normalization of the parameters of arterial circulation and cerebral perfusion. Primary vascular patency was 96.2%, restenosis was not revealed in any observation.Conclusion. Duplex scanning is a highly informative technique for both diagnosing pathological deformities of the vertebral arteries and assessing the restoration of the hemodynamics of the vertebrobasilar system after reconstructive surgery. This method provides the most accurate information on the anatomical form and localization of pathological deformities of the vertebral artery. It also allows quantitative assessment of cerebral blood flow.

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Modern foreign experience of study of vertebral-basilar insufficiency: clinical manifestations and diagnostic challenges.

Cited by 2 publications

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Optimization of Surgical Treatment of Vertebral Artery Tortuosity

Optimization of Surgical Treatment of Vertebral Artery Tortuosity

The potential of duplex scanning in the diagnosis of pathological tortuosity of the vertebral artery

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