Yakovenko L. Diagnostics and surgical treatment of veretebral arteries stenosis

We studied results of examination and surgical treatment of 274 patients with impairment of cerebral blood flow in vertebro-basilar territory. We found that in 85% of the cases developing of chronic and progressing dyscircular encephalopathy was caused by vertebral arteries stenosis. Clinical signs of the disease characterized by resistance to medical treatment in 97% of those patients and lead to permanent disability in 76% of the cases. Diagnostical examinations according to elaborated algorythm allow to establish grade, nature and location of stenotic lesions, as well to evaluate haemodynamical, morphological and functional manifestation of insufficient blood flow, to ground indications for surgical treatment. Differential use of reconstructive interventions resulted in the clinical improvement in 92% of patients. Effectiveness of the surgery was based on the elimination of all components of stenotic lesions. That leads to improvement of general status in 87,9% of patients, decrease of neurological symptoms caused by cerebrovascular insufficiency in 57,26% of operated patients and increase of haemodynamical parameters in 76% of patients at postoperative examination.