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Updated: Jul 9, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Extracranial vertebral artery intervention
Debabrata Mukherjee1, Guillermo Pineda
1University of Kentucky, Lexington, KY 40536-0200, USA. Mukherjee@uky.edu
Insights
Atherosclerosis commonly causes vertebral artery stenosis. This article focuses on the interventional management of proximal extracranial vertebral artery disease, a significant cause of vertebral artery ischemia.
Area of Science:
- Vascular Surgery
- Neurology
- Interventional Cardiology
Background:
- Atherosclerosis is the leading cause of vertebral artery stenosis.
- Stenosis commonly affects the origin and proximal segments of both extracranial and intracranial vertebral arteries.
- Extracranial vertebral artery (ECVA) disease was historically considered less severe than intracranial disease.
Purpose of the Study:
- To review the interventional management strategies for proximal extracranial vertebral artery (ECVA) disease.
- To highlight the significance of proximal ECVA disease as a cause of vertebral artery ischemia.
Main Methods:
- Review of interventional management techniques for proximal ECVA disease.
- Focus on patient populations experiencing vertebral artery ischemia due to ECVA disease.
Main Results:
- Significant occlusive disease of the proximal vertebral artery is a primary cause of vertebral artery ischemia in many patients.
- Interventional management is a key approach for addressing proximal ECVA disease.
Conclusions:
- Proximal extracranial vertebral artery disease requires focused interventional management.
- Understanding the impact of ECVA disease is crucial for managing vertebral artery ischemia.
Abstract:
Atherosclerosis is the commonest cause of vertebral artery stenosis and has a predilection for the origin and proximal section of the extracranial portion of the vessel and also the intracranial portion of the vessel. Although it has generally been thought that extracranial vertebral artery (ECVA) disease has a more benign outcome compared to intracranial vertebral artery disease, significant occlusive disease of the proximal vertebral artery is the primary cause of vertebral artery ischemia in a significant proportion of patients. We focus on the interventional management of patients with proximal ECVA disease in this article.
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