Vertebral artery stenting using distal emboli protection and transcranial Doppler

Recent studies have shown the feasibility and safety of the percutaneous approach for the treatment of vertebrobasilar disease using either balloon angioplasty alone, coronary stents, or combined angioplasty followed by stenting. The major concern in performing percutaneous procedures for the treatment of obstructive disease of the vertebrobasilar circulation involves the risk of embolic phenomena. We describe the successful treatment of a symptomatic patient with bilateral vertebrobasilar disease utilizing a distal protection filter during stenting with simultaneous use of transcranial Doppler to measure microembolization and vertebral artery blood flow during the procedure.