Faculty Collaboration Database

The natural history of vertebral artery origin stenosis. J Stroke Cerebrovasc Dis 2014 Jan;23(1):e1-4

Date

01/22/2013

Pubmed ID

23332862

DOI

10.1016/j.jstrokecerebrovasdis.2012.12.004

Scopus ID

2-s2.0-84891819349 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

BACKGROUND: We sought to determine the long-term survival and natural history of vertebral artery origin stenosis (VAOS) as it relates to stroke.

METHODS: We retrospectively reviewed clinical data on patients admitted at a single institution for possible stroke between 2004 and 2007 and selected subjects who underwent angiography of the neck. We classified VAOS subjects as having "moderate" to "severe" (≥50%) occlusion. Age-, sex-, and race-matched control subjects with no evidence of VAOS on angiography were selected from our study population. Long-term follow-up data were collected and death certificates were searched for comparison among cases and controls. A Kaplan-Meier curve was plotted based on time to event (stroke or death).

RESULTS: Fifty-eight of the 358 subjects were found to have VAOS (16.2%). Four subjects were excluded because of stenting; therefore, 54 cases and 54 matched controls were included for long-term follow-up analysis. In our study population, we calculated that the relative risk of having a stroke or dying in patients with VAOS was 6 times that of patients without VAOS (P < .02). The observed 5-year survival rate for patients with VAOS was 67% (36/54) compared to 89% (48/54) in control subjects (P < .01).

CONCLUSIONS: Patients with VAOS are at a significantly higher risk of having a stroke or dying. Subsequent prospective, multicenter studies are needed to validate our results.

Author List

Thompson MC, Issa MA, Lazzaro MA, Zaidat OO

Author

Marc A. Lazzaro MD Associate Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Cerebral Angiography
Female
Follow-Up Studies
Humans
Ischemic Attack, Transient
Kaplan-Meier Estimate
Magnetic Resonance Angiography
Male
Middle Aged
Retrospective Studies
Stents
Stroke
Survival Analysis
Tomography, X-Ray Computed
Vertebral Artery
Vertebrobasilar Insufficiency
Young Adult