We report a hybrid surgery including endovascular aneurysm repair and debranching procedures to treat a patient with a complex right subclavian artery aneurysm. The patient was a 70-year-old woman who presented with dry cough and hoarseness. The aneurysm was characterized by the absence of a proximal neck, and involvement of the origin of the right vertebral artery. She underwent carotid-verteb...

Background and Purpose: Vertebral artery dissection causes endothelial changes and stenosis that may lead to recurrent ischemic neurological events. The diagnosis may not be obvious because the dissection may be painless and "spontaneous" (no obvious trauma). Magnetic resonance angiography has increasingly been used to screen patients for this disorder, but its accuracy has not yet been establi...

Endovascular therapy, including percutaneous transluminal angioplasty with or without stenting, is considered investigational for the management of extracranial vertebral artery disease. There is insufficient evidence to support a conclusion concerning the health outcomes or benefits associated with this procedure. Policy Guidelines The extracranial vertebral artery is considered to be segments...

The right vertebral artery most commonly originates as the first branch of the right subclavian artery. Although anatomical variants of the aortic arch are commonly encountered on cross-sectional imaging, certain variants of the right vertebral artery are exceedingly rare. In this report, we present 3 cases of aberrant right vertebral artery arising as the last branch of the aortic arch, a very...

Dissecting aneurysms of the vertebrobasilar system are infrequent. Most of the commonly reported cases describe iatrogenic or traumatic aneurysms of the extracranial vertebral artery. Spontaneous dissecting aneurysms of the extracranial vertebral artery are frequently associated with carotid artery lesions; however, such association is poorly documented in the literature. We describe a case of ...

Ruptured intracranial vertebral artery dissection is a cause of non-traumatic subarachnoid hemorrhage. Urgent intervention should be considered to prevent fatal rebleeding. Endovascular parent artery occlusion, which is the initial treatment of choice, is not suitable for patients with a hypoplastic or occlusive contralateral vertebral artery. We report a case of ruptured vertebral artery disse...

Though unilateral blood distribution of the vertebral artery has not been studied in humans, it is significant when considering the ischemic events especially embolic occlusion in vertebrobasilar system. To clarify the blood distribution, Krypton-81m was continuously infused into the vertebral arteries of 10 patients. Radioactivity was recorded by a rotating gamma camera. The perfusion images, ...

Vertebral artery hypoplasia (VAH) can be easily overlooked if the contralateral side vertebral artery is intact, because of compensation by the contralateral artery or cerebral collateral network. The clinical relevance and hemodynamic impact of VAH is still controversial. However, VAH has recently been considered a risk factor for posterior circulation ischemia. Ischemic stroke is seldom cause...

Traumatic vertebral arteriovenous fistulae (AVFs) are relatively uncommon lesions that often follow penetrating wounds of the neck or iatrogenic arterial trauma [1-7]. Such posttraumatic single-hole fistulae differ from congenital arteriovenous malformations, which are composed of multiple communications between the cervical arteries and an abnormal vascular nidus [8] . True single-hole vertebr...

Vertebral artery injury (VAI) is a rare but serious complication of cervical spine surgery. Instrumented posterior surgery of the upper cervical spine places the vertebral artery at the highest risk of injury. However, VAI during removal of cervical internal fixation is really rare and unexpected. We present a case of 52-year-old male patient who suffered VAI during removal of C1-C2 pedicle scr...