Suboccipital approach to the distal vertebral artery

Slides:

Advertisements

Similar presentations

Blunt injury to the internal carotid artery at the base of the skull: Six cases of venous graft restoration Yves S. Alimi, Pascal Di Mauro, Edouard Fiacre,

Advertisements

A review of 100 consecutive reconstructions of the distal vertebral artery for embolic and hemodynamic disease Ramon Berguer, MD, PhD, Mark D. Morasch,

Neonatal thoracoabdominal aortic thrombosis associated with the umbilical artery catheter: Successful management by transaortic thrombectomy Peter D.

Popliteal artery stenosis caused by a Baker's cyst

Marshall E. Benjamin, MD, E. Jerry Cohn, MD, William A

A. C. Moncure, MD, D. C. Brewster, MD, R. C. Darling, MD, W. M

Arterial injuries in the thoracic outlet syndrome

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease Joseph P. Archie, PhD, MD Journal of Vascular.

Two case presentations and surgical management of Bow Hunter's syndrome associated with bony abnormalities of the C7 vertebra Victoria Lee, BS, Thomas.

Enrico Ascer, MD, Frank J. Veith, MD, Sushil K. Gupta, MD

Back of the neck Muscles of the back-

Bypass to the perigeniculate collateral vesselsA useful technique for limb salvage: Preliminary report on 22 patients Xavier Barral, MD, Gholam R. Salari,

Todd M. Gerkin, MD, Hugh G. Beebe, MD, David M. Williams, MD, Jess R

Richard J. Sanders, M.D., Susan Raymer Journal of Vascular Surgery

Mark T. Benson, MB, ChB, John D. Hamer, ChM

Exposure of the anterior tibial artery by medial popliteal extension

Suboccipital approach to the distal vertebral artery

A new valvulotome for in situ bypass grafts

Martin Björck, MD, PhD, David Bergqvist, MD, PhD

Ramon Berguer, M.D., Ph.D. Journal of Vascular Surgery

Michael A. Coady, MD, MPH, Felix Adler, BS, Javier J

Mesenteric and portal vein thrombosis in a young patient with protein S deficiency treated with urokinase via the superior mesenteric artery Deron J.

Ambulatory venous pressure revisited

Marshall E. Benjamin, MD, E. Jerry Cohn, MD, William A

Arterial injuries in the thoracic outlet syndrome

Blunt injury to the internal carotid artery at the base of the skull: Six cases of venous graft restoration Yves S. Alimi, Pascal Di Mauro, Edouard Fiacre,

Ramon Berguer, MD, PhD, J.A. Gonzalez, MD Journal of Vascular Surgery

Contemporary outcomes after distal vertebral reconstruction

COMBINED INTERNAL CAROTID AND HYPOGLOSSAL ARTERY ENDARTERECTOMIES IN A SYMPTOM-FREE PATIENT WITH CONTRALATERAL INTERNAL CAROTID ARTERY OCCLUSION Raymond.

Ruptured ovarian artery aneurysm: A case report

De novo renal artery aneurysm presenting 6 years after transplantation: A complication of recurrent arterial stenosis? Shelby H. Burkey, MD, Miguel A.

Lateral approach to the popliteal artery

Popliteal artery entrapment: An evolving syndrome

Joseph L. Mills, MD, Spence M. Taylor, MD, Roy M. Fujitani, MD

Use of the splenic and hepatic arteries for renal revascularization

William H. Edwards, M.D., Joseph L. Mulherin, M.D.

Revascularization of cerebral ischemia after previous bilateral extracranial-intracranial bypass procedures V.S. Sottiurai, MD, PhD, L. Herbert, MD,

Supraceliac aortomesenteric bypass for intestinal ischemia

Margruder C. Donaldson, M. D. , William H. Druckemiller, M. D

Objective tinnitus resulting from internal carotid artery stenosis

Richard E. Parsons, MD, Michael L. Marin, MD, Frank J

Vein compression by arterial aneurysms

Ashok Shaha, MD, T. Phillips, MD, T. Scalea, MD, P. Golueke, MD, J

Ramon Berguer, MD, PhD, Lisa M. Flynn, MD, Ronald A

A simple method for combined carotid endarterectomy and correction of internal carotid artery kinking Eric S. Chino, M.D. Journal of Vascular Surgery

A. C. Moncure, MD, D. C. Brewster, MD, R. C. Darling, MD, W. M

Robert A. McCready, MD, Steven K. Miller, MD, Ronald C

James R. Burnett, MB, BS, FRACS, Robert J. Lusby, MD, FRCS, FRACS

The fate of the donor artery in extraanatomic revascularization

Ambulatory venous pressure revisited

Carotid involvement in aortic dissection diagnosed by duplex scanning

Follow-up evaluation after renal artery bypass surgery with use of carbon dioxide arteriography and color-flow duplex scanning Timothy R.S. Harward,

James E. Edwards, MD, Lloyd M. Taylor, MD, John M. Porter, MD

Victor J. Celani, MD, William Gee, MD, Harry A. Kaupp, MD, Theodore J

Seizures following subclavian-carotid bypass

Carotid biaxillary bypass: A new operation

Kim J. Hodgson, M.D., David S. Sumner, M.D.

Popliteal artery entrapment: Diagnosis by computed tomography

Intimal intussusception: Unusual complication of dissecting aneurysm

Intramural dissection of superior mesenteric artery

Surgical correction of abdominal aortic coarctation and hypertension

Ramon Berguer, M.D., Ph.D. Journal of Vascular Surgery

Carotid body tumor: Atypical angiogram of a functional tumor

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease Joseph P. Archie, PhD, MD Journal of Vascular.

Popliteal entrapment syndrome: A report of tibial nerve entrapment

Technique in direct venous valvuloplasty

Rotational vertebral artery occlusion secondary to completely extraosseous vertebral artery Rachel Rendon, BS, Kristyn Mannoia, MD, Steven Reiman, MD,

Rupture of inferior thyroid artery aneurysm

Rotational vertebral artery occlusion secondary to completely extraosseous vertebral artery Rachel Rendon, BS, Kristyn Mannoia, MD, Steven Reiman, MD,

The posterior approach to popliteal-crural bypass

Presentation transcript:

Suboccipital approach to the distal vertebral artery Ramon Berguer, MD, PhD Journal of Vascular Surgery Volume 30, Issue 2, Pages 344-349 (August 1999) DOI: 10.1016/S0741-5214(99)70146-1 Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 The pars atlantica of the vertebral artery. The course of the C1 nerve is outlined. Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Insert, Incision to expose the suboccipital segment of the vertebral artery. Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 A, The upper fibers of the trapezius and the splenius capitis have been divided. The semispinalis is being cut. B, The obliquus capitis superior is divided. The vertebral artery lies beneath it. At the lateral edge of the incision, the spinal accessory nerve is tagged with a loop. C, The vertebral artery rests on the posterior lamina of C1, covered by a dense venous plexus. A muscular branch to the obliquus capitis inferior is seen. D, Part of the venous plexus is coagulated with bipolar cautery. The suboccipital vertebral, held by a loop, is dissected to the atlanto-occipital membrane. E, The distal cervical internal carotid has been isolated by retracting medially the vagus and hypoglossal nerves. A vein graft is anastomosed to the internal carotid artery. F, A completed carotid-vertebral bypass graft, arching over the lamina of C1. Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Postoperative computed tomography scan, showing a laminectomy of C1 to correct extrinsic compression of the vertebral artery at this level. Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A vertebral artery dissection (between arrows ) that extends to the level of the transverse process of C1. The artery is occluded proximal to the lower arrow . Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Selective arteriograms of a single dominant left vertebral artery. A, With the neck in the neutral position, the anatomy of the distal vertebral and basilar arteries is normal. Note the absence of posterior communicating arteries. B, The same artery, with the neck rotated, shows severe compression at the level of the pars atlantica and faint filling of the posterior fossa. C, The postoperative view after laminectomy, with the head rotated, is normal. Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 A, B, Postoperative arteriograms in two patients after an internal carotid to suboccipital vertebral bypass grafting procedure. Note in both cases the level of origin of the bypass graft in the upper cervical carotid. Journal of Vascular Surgery 1999 30, 344-349DOI: (10.1016/S0741-5214(99)70146-1) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions