Abstract
Pathology at the origin of the vertebral artery may be the cause of incapacitating vertebrobasilar insufficiency (VBI). Preoperative diagnosis is made primarily on angiographic criteria. We compared intraoperative and angiographic findings in 30 patients and found important diagnostic discrepancies in patients with a caudal, ventral or dorsal origin of the vertebral artery. In their angiograms, vessel superimposition led us to over look 3 ostial stenoses and 10 stenoses due to kinking. Angiographic assessment of patients with VBI can be difficult. Adequate visualisation of the origin of the vertebral artery is mandatory for accurate diagnosis.
Similar content being viewed by others
References
Mathias K (1976) Ursachen der vertebrobasilären Insuffizienz und mögliche Fehlbeurteilungen im Angiogram. Radiologe 16: 193–199
Spetzler RF, Hadley MN, Martin NA, Hopkins LN, Carter LP, Budny J (1987) Vertebrobasilar insufficiency. 1: Microsurgical treatment of extracranial vertebrobasilar disease. J Neurosurg 66: 648–661
Diaz FG, Ausman JI, Reyes RA de los, Pearce J, Shrontz C, Pak H, Turcote J (1984) Surgical reconstruction of the proximal vertebral artery. J Neurosurg 61: 874–881
Chourtheoux P, Tournade A, Thèron J, Henriet JP, Maiza D, Derlon JM, Pelouze G, Evrard O (1985) Transcutaneous angioplasty of vertebral artery atheromatous ostial stricture. Neuroradiology 27: 259–264
Kachel R, Ritter H, Grossmann K, Hamm KD (1986) Die perkutane transluminale Dilatation (PTD) von Abgangsstenosen der Arteria vertebralis. Zentralbl Chir 111: 709–716
Tschammler A, Landwehr P, Hohmann M, Moll R, Wittenberg G, Lackner K (1991) Farbkodierte Duplexsonographie der extracraniellen hirnversorgenden Arterien: diagnostische Aussagekraft und Fehlerquellen im Vergleich zum i. a. DSA. RÖFÖ 155: 452–459
Davis PC, Nilsen B, Braun IF, Hoffman JC Jr (1986) A prospective comparison of duplex sonography vs angiography of the vertebral arteries. AJNR 7: 1059–1064
Trattnig S, Schwaighofer B, Hübsch P, Schwarz M, Kainberger F (1991) Color-coded doppler sonography of vertebral arteries. J Ultrasound Med 10: 221–226
Hankey GJ, Warlow CP (1991) The role of imaging in the management of cerebral and oculor ischaemia. Neuroradiology 33: 381–390
Bruckmann H, Hutschreuter M, Ringelstein EB, Zeumer H (1987) Die Bedeutung der Vertebralisangiographie für die Diagnostik und Therapie der vertebro-basilaren Durchblutungsstörungen unter besonderer Berücksichtigung gefäßrekanalisierender Verfahren. Radiologe 27: 495–501
Datsetan MR, Skerhut HEI (1990) Rotational vertebrobasilar insufficiency secondary to vertebral artery occlusion from fibrous band of the longus colli muscle. Neuroradiology 32: 514–515
Comerota AJ, Maurer AH (1992) Surgical correction and SPECT imaging of vertebrobasilar insufficiency due to unilateral vertebral artery stenosis. Stroke 23: 602–606
Caplan LR, Wolpert SM (1991) Angiography in patients with occlusive cerebrovascular disease: views of a stroke neurologist and neuroradiologist. AJNR 12: 593–60
Tschabitscher M, Fuss FK, Matula C, Klimpel S (1991) Course of the arteria vertebralis in its segment V1 from the origin to its entry into the foramen processus transversi. Acta Anat 140: 373–377
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Farrés, M.T., Grabenwöger, F., Trattnig, S. et al. Stenoses of the first segment of the vertebral artery: difficulties in angiographic diagnosis. Neuroradiology 38, 6–10 (1996). https://doi.org/10.1007/BF00593205
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00593205