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An easy adjustable method of ectatic vertebrobasilar artery transposition for microvascular decompression.
Clin Neurol Neurosurg. 2012 Sep; 114(7):951-6.CN

Abstract

BACKGROUND

Microvascular decompression (MVD) of trigeminal neuralgia (TN) or hemifacial spasm (HFS) caused by an elongated, tortuous or enlarged vertebral or basilar artery has a higher rate of incomplete cure.

OBJECTIVE

We used an easily applied and adjustable method of vertebrobasilar artery transposition and fixation to improve the immediate surgical outcome of MVD of TN or HFS due to compression by an ectatic vertebrobasilar artery system.

METHODS

Vertebral or basilar artery transposition was performed using the vascular sling with a strip of unabsorbable dural tape. The vertebrobasilar artery-sling complex was then fixed to the dura over the petrous bone by aneurysm clip through the dural bridge. The direction and angle of traction on the vertebrobasilar artery was adjustable using different lengths of clip or the horizontal level of the dural bridge.

RESULTS

The sling and clip fixation method has been applied in 7 cases of MVD associated with vertebral or basilar artery compression. All 3 patients with TN and one with HFS had total remission of symptoms right after the procedure; one patient was completely free of spasm within 1 week after MVD and one had achieved 80% improvement of spasm in his last clinical visit 3 months after MVD. There was no major surgical complication in these 7 patients. Surprisingly, refractory hypertension was unexpectedly cured in one patient with TN following the procedure.

CONCLUSION

The vertebrobasilar artery transposition and fixation method used in the present study provided surgeons an easy and adjustable way to perform MVD safely and effectively.

Authors+Show Affiliations

Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22390889

Citation

Lin, Chun-Fu, et al. "An Easy Adjustable Method of Ectatic Vertebrobasilar Artery Transposition for Microvascular Decompression." Clinical Neurology and Neurosurgery, vol. 114, no. 7, 2012, pp. 951-6.
Lin CF, Chen HH, Hernesniemi J, et al. An easy adjustable method of ectatic vertebrobasilar artery transposition for microvascular decompression. Clin Neurol Neurosurg. 2012;114(7):951-6.
Lin, C. F., Chen, H. H., Hernesniemi, J., Lee, C. C., Liao, C. H., Chen, S. C., Chen, M. H., Shih, Y. H., & Hsu, S. P. (2012). An easy adjustable method of ectatic vertebrobasilar artery transposition for microvascular decompression. Clinical Neurology and Neurosurgery, 114(7), 951-6. https://doi.org/10.1016/j.clineuro.2012.02.021
Lin CF, et al. An Easy Adjustable Method of Ectatic Vertebrobasilar Artery Transposition for Microvascular Decompression. Clin Neurol Neurosurg. 2012;114(7):951-6. PubMed PMID: 22390889.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An easy adjustable method of ectatic vertebrobasilar artery transposition for microvascular decompression. AU - Lin,Chun-Fu, AU - Chen,Hsin-Hung, AU - Hernesniemi,Juha, AU - Lee,Cheng-Chia, AU - Liao,Chih-Hsiang, AU - Chen,Shao-Ching, AU - Chen,Min-Hsiung, AU - Shih,Yang-Hsin, AU - Hsu,Sanford P C, Y1 - 2012/03/04/ PY - 2011/11/06/received PY - 2012/01/19/revised PY - 2012/02/12/accepted PY - 2012/3/7/entrez PY - 2012/3/7/pubmed PY - 2012/12/10/medline SP - 951 EP - 6 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 114 IS - 7 N2 - BACKGROUND: Microvascular decompression (MVD) of trigeminal neuralgia (TN) or hemifacial spasm (HFS) caused by an elongated, tortuous or enlarged vertebral or basilar artery has a higher rate of incomplete cure. OBJECTIVE: We used an easily applied and adjustable method of vertebrobasilar artery transposition and fixation to improve the immediate surgical outcome of MVD of TN or HFS due to compression by an ectatic vertebrobasilar artery system. METHODS: Vertebral or basilar artery transposition was performed using the vascular sling with a strip of unabsorbable dural tape. The vertebrobasilar artery-sling complex was then fixed to the dura over the petrous bone by aneurysm clip through the dural bridge. The direction and angle of traction on the vertebrobasilar artery was adjustable using different lengths of clip or the horizontal level of the dural bridge. RESULTS: The sling and clip fixation method has been applied in 7 cases of MVD associated with vertebral or basilar artery compression. All 3 patients with TN and one with HFS had total remission of symptoms right after the procedure; one patient was completely free of spasm within 1 week after MVD and one had achieved 80% improvement of spasm in his last clinical visit 3 months after MVD. There was no major surgical complication in these 7 patients. Surprisingly, refractory hypertension was unexpectedly cured in one patient with TN following the procedure. CONCLUSION: The vertebrobasilar artery transposition and fixation method used in the present study provided surgeons an easy and adjustable way to perform MVD safely and effectively. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/22390889/An_easy_adjustable_method_of_ectatic_vertebrobasilar_artery_transposition_for_microvascular_decompression_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(12)00104-7 DB - PRIME DP - Unbound Medicine ER -