Stroke, Vol 17, 938-942, Copyright © 1986 by American Heart Association
NA Moufarrij, JR Little, AJ Furlan, JR Leatherman and GW Williams
Forty-four patients with greater than or equal to 50% stenosis of a distal
vertebral artery (VA) and/or basilar artery (BA) were followed up for an
average of 6.1 years. Angiography was performed for definite
vertebrobasilar (VB) transient ischemic attacks (TIA) in 19 (43%), for VB
infarcts in 13 (30%) and for non localizing symptoms in 12 (27%). Stenosis
in the BA with or without VA involvement was present in 28 patients (64%),
while 16 patients (36%) had occlusive disease in one or both distal VA
sparing the BA. In follow up, 7 patients (16%) had definite VB TIA and 3
patients had possible VB TIA. Eight patients (18%) sustained a stroke, 5 of
which were in the VB territory. The observed stroke rate was 17 times the
expected rate for a matched normal population. Eight patients died during
follow up, three patients due to stroke (2 brainstem infarctions, one
intraventricular hemorrhage). The observed 5 year survival rate was 78%
compared to 90% in a matched normal population. In comparing this data with
our previous study of 93 patients with proximal VA occlusive disease,
distal VB occlusive disease appears to carry a higher risk for brainstem
ischemia.
ARTICLES
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