Vertebral artery Doppler sonography

Duplex Doppler ultrasonography of subclavian steal syndrome--three case reports

Three cases of subclavian steal syndrome were detected by duplex Doppler ultrasonography. Ultrasonography demonstrated retrograde flow with to-and-fro pattern in the right vertebral artery in two cases, and reflux with diastolic flow deceleration in one case. Interventional treatment with stenting was successfully performed in two cases and conservative treatment was given in one case. Ultrasonography is an effective noninvasive method for the evaluation of the vertebral artery, and should become a routine part of cerebrovascular examinations.

The role of vertebral and internal carotid artery disease in the pathogenesis of vertebrobasilar transient ischemic attacks

Color-coded duplex sonography has improved the evaluation of the hemodynamics of the vertebral arteries (VA). A reliable differentiation between a normal vessel, hypoplasia, stenosis and occlusion of VA can now be made. We studied two groups of patients in a prospective study with isolated carotid artery disease (n = 48), and with a combination of carotid and vertebral artery disease (n = 14), to determine the role of VA in the pathogenesis of transient ischemic attacks (TIAs) in the vertebrobasilar system. Apart from the existing arteriosclerotic changes of the internal carotid arteries, the condition of the VA was of importance for the occurrence of TIAs in the vertebrobasilar territory. We found that 8% of the patients with isolated hemodynamically relevant stenosis or occlusion of one or both internal carotid arteries had a TIA in the vertebrobasilar territory. Patients with combined carotid and vertebral artery disease had an increase of TIAs in the same region in 71%. The high rate of TIAs in this group might be attributed to the combined effect of carotid and vertebral artery disease, as a third group (n = 30) with isolated vertebral artery disease showed TIAs in only 13%.