Vertebral artery stenosis: Long-term follow-up

Abstract

Ninety-six patients with ⩾50% unilateral vertebral artery (VA) stenosis were followed up for an average of 4.6 years. In 89 patients (93%) at least one VA origin was involved, while the intracranial VA was affected in 3 patients (3%). Seventy-four patients (77%) had ⩾50% stenosis of at least one internal carotid artery, of whom 52 underwent carotid end arte recto my. None of the patients had definite vertebro-basilar transient ischemic attacks (VB TIA). Nineteen patients (19.8%) experienced nonlocal izing symptoms possibly compatible with VB TIA, none of whom had a stroke. Twenty-three patients (24%) had strokes. The only two patients (2%) who sustained a brainstem infarction had fatal strokes and both were known to have basilar artery stenosis in addition to their VA stenosis. The observed stroke rate was 8.5 times the expected infarction rate for a normal population. Forty patients died during follow up. The observed 5-year survival rate was 60% compared to 87% in a matched normal population. Eight deaths (20% of all deaths) were caused by stroke and 21 deaths (52.5% of all deaths) were cardiac related. © 1984 American Heart Association, Inc.