Two Cases of Vertebral Artery Transposition for Treatment of Vertebral Artery Stenosis

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  • 椎骨動脈転位術を施行した椎骨動脈狭窄症 2 例の検討

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We encountered 2 cases of vertebral artery transposition for the treatment of the vertebral artery stenosis. Case 1 was a 51-year-old woman. She had a visual disorder and careful examination revealed stenosis at the origin of the bilateral vertebral arteries and the left subclavian artery. Case 2 was a 66-year-old woman who frequently had sudden attacks of vertigo and careful examination revealed stenosis at the origin of the left vertebral artery and the left subclavian artery. Both cases were successfully treated with vertebral artery transposition and the clinical symptoms disappeared. <br>Unlike stenosis of the carotid artery and the subclavian artery, therapeutic indications for vertebral artery stenosis are unclear. Generally, surgical indications for the vertebral artery stenosis are thought to be lesions with clinical symptoms, however, consensus has not yet been obtained. Recently, there are many case series suggesting that endovascular surgery at this site is safe and effective. However, there have been no randomized trials comparing open surgery with endovascular surgery. Moreover, the long-term outcome of endovascular surgery also remains unclear. Further investigation is needed for endovascular surgery to become the first line treatment of vertebral artery stenosis.

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