Vertebral arterial stenosis

Case contributed by Mariia Anisimova
Diagnosis almost certain


Preventive examination due to high blood level of cholesterol. Asymptomatic.

Patient Data

Age: 55
Gender: Male

Figure 1: visualized elayzing effect in the ostium of the vertebral artery.

Figure 2: increase in blood flow in the segment V1.

Figure 3: rendered decrease in V2 segment blood flow velocity.

Case Discussion

Vertebral stenosis is associated with a high risk of posterior circulation stroke, therefore it needs to be quickly and accurately identified. The gold standard of diagnosis of vertebral arteries stenosis is considered to be intra-arterial angiography. Duplex ultrasound has low sensitivity and will miss vertebral stenosis 1,2.

Hemodynamically significant stenosis of the vertebral artery requires surgery 3. In this case, in addition to turbulence and increase in blood flow in the ostium of vertebral artery, we can see the reduction in blood flow in segment V2. Such changes are consistent with hemodynamically significant stenosis (more than 70%).

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