The surgical reconstruction of the proximal subclavian and vertebral artery.

Endarterectomy, bypass, or direct arterial anastomosis are used to restore flow in a compromised vertebral or subclavian artery. During 20 years of experience in surgical relief of stenosis of the proximal vertebral and subclavian arteries, we now prefer an anastomosis between the involved vertebral or subclavian artery. We have performed 411 such procedures. There has been one death (0.2%), with reoperation necessary in three patients (0.0%). No neurologic morbidity has been associated with this procedure.