Six-year history of intermittent symptomatic bilateral vertebral artery stenosis: Imaging and therapeutic intervention.
Christian Kenneth KerutClaudie SheahanMalachi SheahanPublished in: Echocardiography (Mount Kisco, N.Y.) (2020)
A 66-year-old man was evaluated for a 6-year history of disabling symptoms of typical intermittent vertebrobasilar (VB) insufficiency. Duplex scanning was "normal," but computed tomographic angiography (CTA) revealed significant bilateral proximal vertebral artery (VA) disease. Angiography with stent placement with the proximal right VA resulted in resolution of symptoms. Symptoms of VB insufficiency may occur from bilateral VA disease, most often involving both proximal segments. Duplex ultrasound has high specificity but relatively low sensitivity for finding hemodynamically significant VA disease. Further imaging with CTA or magnetic resonance angiography (MRA) will help in identification of disease. As with this patient, invasive angiography with percutaneous stenting of the most significantly stenosed VA often results in resolution of symptoms of VB insufficiency.
Keyphrases
- optical coherence tomography
- magnetic resonance
- computed tomography
- high resolution
- case report
- randomized controlled trial
- magnetic resonance imaging
- sleep quality
- high intensity
- single molecule
- physical activity
- mass spectrometry
- photodynamic therapy
- contrast enhanced
- body composition
- fluorescence imaging
- postmenopausal women
- endovascular treatment
- contrast enhanced ultrasound