STENOSES OF THE FIRST SEGMENT OF THE VERTEBRAL ARTERY - DIFFICULTIES IN ANGIOGRAPHIC DIAGNOSIS

Pathology at the origin of the vertebral artery may be the cause of in capacitating vertebrobasilar insufficiency (VBI). Preoperative diagnos is is made primarily on angiographic criteria. We compared intraoperat ive and angiographic findings in 30 patients and found important diagn ostic discrepancies in patients with a caudal, ventral or dorsal origi n 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. Adequa te visualisation of the origin of the vertebral artery is mandatory fo r accurate diagnosis.