AI Article Synopsis
- A 66-year-old man experienced severe symptoms of vertebrobasilar insufficiency for six years, but his initial duplex scans appeared normal.
- Advanced imaging techniques like computed tomographic angiography revealed significant disease in both proximal vertebral arteries, prompting the need for invasive angiography.
- The patient underwent stent placement in the right vertebral artery, which successfully alleviated his symptoms, highlighting the importance of additional imaging in diagnosing vertebral artery disease.
Article Abstract
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.
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| http://dx.doi.org/10.1111/echo.14656 | DOI Listing |
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