Surgical Therapy for Vertebrobasilar Insufficiency.

Vertebrobasilar insufficiency causes vertigo, motor disturbance, cranial nerve dysfunction, and so on. They are often treated with medication and rarely surgically treated, because diagnosis of vertebrobasilar insufficiency is difficult. We report the methods of surgical operation for vertebrobasilar insufficiency and its result. Twenty-nine patients were admitted to our hospital for operation of vertebrobasilar insufficiency from January 1997 to December 2001. The 12 males and 17 females were aged 42-83 years old (mean 66 years old). Symptoms were vertigo in 18, tinnitus in 6, transient ischemic attack in 4, and no symptoms in 1. Diagnosis was made based on magnetic resonance angiography, three-dimensional computed tomographic angiography, and angiogram. The operative procedure was vertebral to carotid transposition in 8, correction for winding vertebral artery in 2, cervical osteophytectomy in 18, and subclavian artery stenting in 1. In all but 1 case preoperative symptoms improved. The 1 exception was sick sinus syndrome, which was diagnosed postoperatively. Diagnosis for vertebrobasilar insufficiency was mainly based on neurological examination and radiographic findings, but it was difficult. Evaluating these data, operative indication should be decided.