Vertebrobasilar insufficiency historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

In a long time in history,the VBI didn’t arouse enough focus because it is suppoesd to present only relatively benign synptoms and better outcomes. With the development of the diagnosis and perception, the VBI is believed to present a high recurrent risk and deserve a positive treatment and prevention.

The first surgical correction of vertebral artery stenosis was published by Crawford and De Bakey in 1958.^[1] Transposition of the proximal vertebral artery to the common carotid was described by Clark and Perry in 1966.^[2] The saphenous vein was used to bypass vertebral artery origin stenoses during 1970s.^[3] The approach to the distal vertebral artery was first described by Matas^[4]and was used for the treatment of traumatic injury.And in 1978,the carotid endarterectomy was proved to produced relief of symptoms in 90% of the patients.^[5] In 1981, Motarjeme et published the first case of vertebral artery origi angioplasty.^[6] In the recent 30 years, different kinds of surgery was rapidly developed to treat the VBI, such as fenestration, passby surgery. With the development of interventional techniques, more and more attemps have been made to treat the VBI, but there isn’t enough comparative evidence to support the benefit of interventional therapy.

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