Endovascular therapy of vertebral artery disease

Vertebral artery (VA) disease processes that are potentially treatable by endovascular means include extracranial atherosclerotic disease, arterial dissection, or blunt or penetrating trauma. Approximately 20 % of cerebral ischemic events involve the posterior circulation, and the extracranial VA is the most common source of symptoms. Risk factors for VA extracranial atherosclerotic disease are similar to those affecting the carotid circulation, although VA stenosis seems more common in the white population, and plaques at the origin of the VA seem more stable and less likely to present with ulceration and/or hemorrhage.