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Vertebral Artery Stenosis

  • Cerebrovascular Disease and Stroke (S Silverman, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Vertebral artery stenosis is a common condition associated with a very high risk of stroke. The goal of this review is to summarize the pathophysiology and natural history of vertebral artery stenosis and to evaluate the efficacy of medical and endovascular therapies.

Recent findings

Early and aggressive initiation of medical care combined with advancements in antithrombotic and lipid-lowering therapies has substantially reduced the risk of stroke due to vertebral artery stenosis. Endovascular therapy does not appear to be beneficial with extracranial vertebral artery stenosis and appears harmful with intracranial vertebral artery stenosis.

Summary

Risk of stroke due to symptomatic vertebral artery stenosis can be significantly reduced with implementation of standardized best medical therapy protocols focusing on ultra-early dual antiplatelet therapy, high-intensity statin therapy + novel lipid-lowering agents, and aggressive risk factor control. Endovascular therapy with angioplasty and stenting is not likely to play a significant role in treatment.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Neurology, Stamford Health Medical Group and Stamford Hospital, Stamford, CT, USA

    Daniel C. Brooks MD

  2. Department of Neurology, Yale University School of Medicine, P.O. Box 208018, New Haven, CT, 06520-8018, USA

    Joseph L. Schindler MD

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Correspondence to Joseph L. Schindler MD.

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Brooks, D.C., Schindler, J.L. Vertebral Artery Stenosis. Curr Treat Options Cardio Med 22, 35 (2020). https://doi.org/10.1007/s11936-020-00832-y

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