Complementary advantages of microsurgical treatment for vertebral artery dolicoarteriopathies: Mitigating symptoms of restless leg syndrome in refractory vertebrobasilar insufficiency

Year 2024, Volume: 37 Issue: 2, 224 - 230, 31.05.2024

Efecan Cekic , İskender Samet Daltaban , Mehmet Erkan Ustun

https://doi.org/10.5472/marumj.1479815

Abstract

Objective: This retrospective study examines the impact of microsurgical treatment on vertebral artery (VA) dolicoarteriopathies and
associated restless leg syndrome (RLS) in patients with refractory vertebrobasilar insufficiency (VBI).
Patients and Methods: We analyzed 78 patients with grade 2 and 3 kinks, and found out that the targeted microsurgical interventions,
primarily designed to address VBI, improved secondary RLS symptoms in 12 patients. Procedures included arteriolysis and, depending
on severity, grafting. Statistical analysis was conducted using Stata 16 (StataCorp LP, Texas, USA).
Results: In twelve patients aged 55 to 72 years with refractory VBI and drug-resistant RLS, micro-neurosurgical correction of V1
segment dolicoarteriopathy, abnormal elongation and kinks in the artery, demonstrated promising outcomes. Postoperatively, 83.33%
(10 patients) reported complete resolution of RLS symptoms, and 16.66% (2 patients) experienced partial symptom relief (p<0.05).
Overall, 86.8% of various VBI-related symptoms were significantly improved or resolved (p<0.05). The microsurgical technique,
avoiding traditional flow-arresting procedures, proved to be highly effective in this preliminary study with no mortality and minimal
temporary complications, underscoring its potential treatment avenue for such complex neurovascular conditions.
Conclusion: This study illuminates the relationship between VBI and RLS, proposing a potential vascular etiology for RLS, and
highlights the need for a broader diagnostic approach for patients with refractory VBI.

Keywords

Vertebral artery dolicoarteriopathy, Microsurgical treatment, Restless leg syndrome, Vertebrobasilar insufficiency

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