The operative technique of shunting to the third (V3) segment of the vertebral artery

Vachev A.N., Dmitriev O.V.

Clinic and Chair of Hospital Surgery of the Samara State Medical University of the RF Public Health Ministry, Samara, Russia

The authors provide a detailed description of the step-by-step technique of performing the operation of shunting to the V3 segment of the vertebral artery in patients with clinical manifestations of vertebrobasilar insufficiency (VBI). Reported are surgical outcomes in a total of 57 patients with VBI. Of these, 5 patients underwent arterial bypass grafting and 52 patients endured autovenous shunting. One patient developed shunt thrombosis in the early postoperative period and, unfortunately, died, with the remaining 51 shunts being patent. At 3 years of follow up, shunt thrombosis occurred in four (80%) patients with the arterial bypass and only in one (1.7%) of the 52 autovein-treated patients. The total duration of postoperative follow up amounted to 10 years.

Long-term freedom from VBI clinical manifestations was achieved in 88.7% of patients after 3 years and in 78.3% after 7 years, with the 3- and 7-year patency rate of the autovenous shunts amounting to 98.1 and 96.2%, respectively.

KEY WORDS: vertebral artery, third (V3) segment, vertebrobasilar insufficiency, reconstructive operation, shunting, operative technique, distal vertebral artery.

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