Endovascular management of vertebral artery disease

Symptomatic disease of the vertebrobasilar circulation is often underdiagnosed and undertreated. In recent years, endovascular revascularization of vertebral artery stenosis has been heralded as a less invasive treatment option in comparison to open surgery, with the inherent risk of morbidity. Although a growing number of case reports and small nonrandomized case series suggest that endovascular intervention in the posterior circulation may be safe and technically feasible, the safety and benefit of angioplasty and stent placement in cases of symptomatic vertebral disease, as compared with the most effective medical therapy, remains to be elucidated.