Vertebral Artery Balloon Angioplasty and Stenting
Stenosis at the origin of the vertebral artery is a recognized risk factor for ischemic stroke. Patients who have symptoms of stroke or transient ischemic attack (TIA) may undergo diagnostic imaging to evaluate the blood vessels of the head and neck. Patients with severe stenosis at the origin of the vertebral artery may benefit from endovascular treatment. After a catheter is navigated to the area of narrowing, a small wire is advanced through the region of stenosis and positioned in the vertebral artery. A balloon-mounted stent is typically used, which is advanced over the wire to the area of narrowing and the balloon is inflated to both expand the narrowing and implant the stent. Additional balloon inflations can be performed before and after the stent placement if needed to ensure adequate expansion of the narrowed region. This procedure is commonly performed with temporary placement of a filter downstream from the region of plaque to capture any debris that may become dislodged during the stent placement.