Carotid-Vertebral or Carotid-Subclavian Transpositions in Supra-Aortic Steno-Occlusive Diseases When Endovascular Therapy Is Unfeasible or Unsuccessful

Background and purpose Despite advances in endovascular therapies, some patients experience vertebral artery stenosis or subclavian occlusion may not benefit from less-invasive angioplasty/stenting. This study described 4 cases which carotid-vertebral transposition (CVT) carotid-subclavian (CST) was adapted when treatment unfeasible unsuccessful. Presentation Case 1: A 65-year-old woman presented with severe of the right ostium, dysplastic left artery, aneurysmal dilatation proximal brachiocephalic trunk. 2: 23-year-woman had at first portion caused by Takayasu's arteritis. Because intervention unfeasible, CVTs were performed 1 2. 3: 73-year-old man total internal carotid artery. 4: 58-year-old experienced complete common Duplex ultrasonography showed reverse flow keeping steal syndrome. Endovascular unsuccessful because wire did cross CSTs concurrent ipsilateral endarterectomy 3 4. Conclusion The present case series demonstrated that CST CVT effective modalities for lesions. Although stenting angioplasty have been advocated as first-line management, should be considered remedy is unfeasible.