Bilateral mechanical rotational vertebral artery occlusion

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Bilateral mechanical rotational vertebral artery occlusion Phong T. Dargon, MD, Conrad W. Liang, MD, PhD, Anmol Kohal, BS, Aclan Dogan, MD, Stanley L. Barnwell, MD, PhD, Gregory J. Landry, MD  Journal of Vascular Surgery  Volume 58, Issue 4, Pages 1076-1079 (October 2013) DOI: 10.1016/j.jvs.2012.12.044 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Duplex ultrasound of right vertebral artery with head in neutral position. Peak systolic velocity 54.6 cm/s. B, Duplex ultrasound of right vertebral artery with head turned right 90 degrees. Peak systolic velocity decreased to 13.4 cm/s. Journal of Vascular Surgery 2013 58, 1076-1079DOI: (10.1016/j.jvs.2012.12.044) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 Selective left vertebral artery angiogram. A, With the head in neutral position there is complete filling of the vessel. B, With the head turned 90 degrees to the right there is a filling defect at C2 (white arrowhead), with notably delayed filling of the vessel. C, Selective right vertebral artery angiogram. With the head in neutral position there is complete filling of the vessel. D, With the head turned 90 degrees to the right, there is a filling defect at C5 (white arrowhead) with notably delayed filling of the vessel. Journal of Vascular Surgery 2013 58, 1076-1079DOI: (10.1016/j.jvs.2012.12.044) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Selective right vertebral artery angiogram, postoperative, with the head in neutral position (A) and turned 90 degrees to the right (B). The filling defect and delayed filling of the right vertebral artery are no longer present. There is irregularity of the vessel at the site of decompression, believed to be due to vasospasm and not hemodynamically significant. Journal of Vascular Surgery 2013 58, 1076-1079DOI: (10.1016/j.jvs.2012.12.044) Copyright © 2013 Society for Vascular Surgery Terms and Conditions