Prevalence of vertebral artery origin stenosis and occlusion in outpatient extracranial ultrasonography.

Abstract

Background and purpose—Vertebral artery origin stenosis prevalence.
Most data on the prevalence of vertebral artery origin (VAo) disease is derived from hospital-based studies
of patients with posterior circulation strokes and TIA. The prevalence of VAo disease in patients without
posterior circulation symptoms or asymptomatic patients is poorly characterized. Our objective was to
examine the prevalence of VAo stenosis and occlusion in consecutive patients, presenting for extracranial
ultrasonography at an outpatient laboratory.
Methods—We retrospectively identified 2490 consecutive extracranial duplex studies performed in an
ambulatory neurovascular ultrasound laboratory. All studies were reviewed for the presence of >50% VAo
stenosis, defined as a PSV > 114 cm/s, and VA occlusion. We also reviewed the prevalence of >50% carotid stenosis, defined as a PSV > 120 cm/s, in the same population, to draw comparisons with VAo stenosis
prevalence.
Results—We identified right VAo stenosis in 52/1955 (2.7%) and occlusion in 74/ 1955 (3.9%) and leftsided VAo stenosis in 45/1973 (2.5%) and occlusion in 64/1973 (3.6%). The prevalence of having any
(either right or left) VAo stenosis or occlusion was 8.2% and 1.4% had bilateral VAo stenosis or occlusion.
Right carotid stenosis and occlusion was found in 236/2399 (9.8%) and 53/2399 (2.2%), and left carotid
stenosis and occlusion in 236/2397 (9.8%) and 45/2397 (1.9%), respectively. Any carotid disease, either
right or left, was present in 18.9% and 4.7% had bilateral carotid disease.
Conclusion—Although less prevalent than cervical carotid disease, we found that ap