To analyze the curative effect of vertebral artery endarterectomy in patients with severe narrowing or occlusion of symptomatic vertebral artery initiation.

Clinical data of 33 patients with vertebral artery endarterectomy admitted to the Neurosurgery Department, Intensive Care Medicine Department, and Stroke Center of Weifang People's Hospital and Shengli Oilfield Central Hospital from October 2016 to December 2021 were collected. All patients with severe narrowing or occlusion involving the onset of the vertebral artery (transient ischemic attack or non-disabled stroke within 6 months) were treated with optimal medication (dual antiplatelet aggregation drugs combined with statin lipid-lowering drugs and risk factors) for more than 3 months. The diameter of the initial vertebral artery lumen and neurological deficits between patients before and after surgery were compared, and the incidence of postoperative complications and vascular restenosis were calculated.

The surgical success rate of 33 patients was 90.91% (30/33). Within 1 week after surgery, there were 3 cases of hoarseness (9.09%), 2 cases of Horner's syndrome (6.06%), 1 case of chylous leakage (3.03%), 1 case of bleeding (3.03%), and 1 case of acute cerebral infarction (3.03%). The initial lumen diameter of 33 patients increased significantly after surgery, and the National Institute of Health stroke scale score decreased significantly compared to preoperative, with statistical significance (P<0.05).

The treatment of severe stenosis or occlusion at the beginning of the vertebral artery with vertebral artery endarterectomy is safe and effective.