Diagnostics And Treatment Of Patients With Blood Circulation Insufficiency In Vertebrobasilar Bed

• Main Authors: A.M. Khachatryan, V.N. Nikolenko, I.I. Sholomov, R.Z. Losev
• Format: Article
• Language: Russian
• Published: Saratov State Medical University 2009-12-01
• Series: Саратовский научно-медицинский журнал
• Subjects: transcranial Doppler ultrasonic investigation; vertebral artery syndrome; vertebral-basilar insufficiency
• Online Access: http://www.ssmj.ru/system/files/200904_629_634.pdf

For improvement of treatment results of patients with vertebrobasilar insufficiency we have analyzed data of medical examination and treatment of 182 patients stayed in clinics of Hospital Surgery and Nervous System Diseases from the 1st of January of 2005 till the 30th of June of 2009. Method of screening diagnostics, quantitative and qualitative blood flow estimation by means of Doppler ultrasonic investigation and angiography have been performed. The cause of blood circulation insufficiency in the vertebrobasilar bed at 87 patients was vertebral artery syndrome and in 95 cases there were the significant hemodynamical damages of blood flow in aorta arch branches and intracranial arteries. The neuroangiotropic therapy has been made for all patients, but the clinical improvement period was short in most cases, more prolonged effect was observed in addition of conservative therapy with plasmapheresis by indications. In the complex treatment of patients with vertebrobasilar insufficiency accompanied by degenerative diseases of spine chemical sympathectomy of vertebral artery in the III segment in the form of procaine and spirit-procaine blockades was made in 116 and 69 cases accordingly. The surgical sympathectomy was made in 15 patients. The surgical operations were made in 62 of 95 patients with significant hemodynamic pathology of blood flow in the vertebrobasilar region. In most cases isolative and combinative reconstructive surgery on carotid arteries was carried out. It played a significant role in blood flow correction. Favorable postoperative results were observed in most cases (93, 5%)