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(Stroke. 2005;36:2047.)
© 2005 American Heart Association, Inc.

Cochrane Corner

Percutaneous Transluminal Angioplasty and Stenting for Vertebral Artery Stenosis

From the Institute of Neurology, University College London, UK.

Correspondence to Prof Martin M. Brown, Box 6 The National Hospital for Neurology and Neurosurgey, Queen Square, London WC1N 3BG, UK. E-mail m.brown@ion.ucl.ac.uk

Key Words: angioplasty • prevention • stenosis • stent • vertebral artery

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
As many as 25% of ischemic strokes occur in the vertebrobasilar region.^1,2 Data on the prognosis of transient ischemic attack and minor stroke from a systematic review has shown that patients with posterior circulation events have a higher risk of subsequent stroke or death in the acute phase (up to 7 days after presenting symptoms) compared with patients who present with anterior circulation symptoms.³ Despite this, much less is known about the natural history of vertebral artery stenosis compared with carotid artery stenosis. Surgery for vertebral artery stenosis is technically difficult, potentially hazardous, and is not considered in most centers. Therefore, vertebral artery stenosis has traditionally been treated conservatively with medical care alone. Nonrandomized case series evidence suggests that vertebral artery stenosis may be treated endovascularly by percutaneous transluminal angioplasty (PTA) and/or stenting,^4–8 potentially offering an alternative to surgery to relieve symptoms caused by significant stenosis.

	Objectives

 
We wished to assess the safety and efficacy of vertebral artery PTA, with or without stenting, combined with medical care, compared with medical care alone, in patients with vertebral artery stenosis.

	Search Strategy

 
We searched the trial register of the Cochrane Stroke Group, the Cochrane Central Register of Controlled Trials, MEDLINE (1966 to 2004), EMBASE (1980 to 2004), and Science Citation Index (1981 to 2004). We also contacted researchers in the field, as well as balloon catheter and stent manufacturers.

	Selection Criteria

 
We sought to identify truly randomized trials comparing any type of endovascular intervention combined with best medical therapy, or best medical therapy alone, in patients with . . . [Full Text of this Article]

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				S Khan, G C Cloud, S Kerry, and H S Markus Imaging of vertebral artery stenosis: a systematic review J. Neurol. Neurosurg. Psychiatry, November 1, 2007; 78(11): 1218 - 1225. [Abstract] [Full Text] [PDF]