Prevalence study of proximal vertebral artery stenosis using high-resolution contrast-enhanced magnetic resonance
1Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Insights
Proximal vertebral artery stenosis is more prevalent than distal vertebral/basilar or internal carotid artery stenosis, particularly in stroke patients. Further research is needed to understand the clinical significance of this finding.
Area of Science:
- Vascular neurology
- Cerebrovascular disease imaging
- Epidemiology of stroke
Background:
- Cerebrovascular stenosis is a significant risk factor for stroke.
- Understanding the prevalence of stenosis in different arteries is crucial for risk stratification.
- Proximal vertebral artery stenosis is less studied compared to other major cerebral arteries.
Purpose of the Study:
- To determine the prevalence of proximal vertebral artery stenosis.
- To compare this prevalence with distal vertebral/basilar artery and internal carotid artery stenosis.
- To analyze prevalence across different patient groups, including stroke and non-stroke populations.
Main Methods:
- High-resolution contrast-enhanced magnetic resonance angiography was performed on 935 patients.
- Patients were categorized into six groups: asymptomatic, minor symptoms, cardiac, hemorrhagic, anterior circulation infarct, and posterior circulation infarct.
- Prevalence of stenosis in proximal vertebral, distal vertebral/basilar, and internal carotid arteries was analyzed.
Main Results:
- Overall prevalence of stenosis was 12.9% (proximal vertebral), 5.5% (distal vertebral/basilar), and 7.2% (internal carotid).
- Stenosis prevalence increased significantly with age for all analyzed arteries (P < 0.0001).
- The posterior circulation infarct group showed the highest prevalence of proximal vertebral artery stenosis (44.4%).
Conclusions:
- Proximal vertebral artery stenosis is more prevalent than stenosis in the distal vertebral/basilar or internal carotid arteries.
- Stenosis prevalence significantly increases with age and is highest in patients with posterior circulation infarct.
- The clinical significance of proximal vertebral artery stenosis requires further investigation.
Purpose:
To evaluate the prevalence of proximal vertebral artery stenosis, compared wiith those of the distal vertebral/basilar artery and extracranial internal carotid artery, in a large population of stroke and non-stroke patients.
Material And Methods:
Nine-hundred-and-thirty-five patients who underwent high-resolution contrast-enhanced magnetic resonance angiography in a regional general hospital were categorized into six groups based on neurological symptoms and disease: an asymptomatic group (n = 182), a minor symptom group with headache or dizziness (n = 519), a cardiac group with coronary artery steno-occlusive disease (n = 15), a hemorrhagic group with old cerebral hemorrhage (n=26), an anterior circulation infarct group (n = 121), and posterior circulation infarct group (n = 72). Prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was analyzed.
Results:
The prevalence of stenosis of the proximal vertebral artery, distal vertebral/ basilar artery, and internal carotid artery was 12.9%, 5.5%, and 7.2%, respectively, in the study population, and rose as the age increased (P < 0.0001 for all arteries). The prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was 3.3%, 0.5%, and 1.1%, respectively, in the asymptomatic group; 8.3%, 2.1%, and 3.7%, respectively, in the minor symptom group; 13.3%, 6.7% and 6.7%, respectively, in the cardiac group; 19.2%, 7.7%, and 7.7%, respectively, in the hemorrhagic group; 27.3%, 8.3%, and 25.6%, respectively, in the anterior circulation infarct group; and 44.4%, 36.1%, and 16.7%, respectively, in the posterior circulation infarct group. This increasing tendency of stenosis accordingly was statistically significant (P < 0.0001 for all arteries).
Conclusion:
The prevalence of proximal vertebral artery stenosis was highest, compared with those of the distal vertebral/basilar artery and internal carotid artery, although the clinical significance of proximal vertebral artery stenosis should be investigated in further studies.
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