Vessel wall imaging of vertebrobasilar artery configurations: associations with posterior circulation infarction in atherosclerosis

Motivation: Vertebrobasilar artery (VBA) configurations have been reported to affect vessel hemodynamics of posterior circulation. High-resolution MR vessel wall imaging (VWI) offers the dual advantages of observing vascular morphology and evaluating high-risk plaques. Goal(s): Our study sought to determine whether certain VBA morphological characteristics are associated with an increased risk of posterior circulation infarction (PCI) using VWI. Approach: A retrospective case-control study of 249 participants (98 PCIs and 151 non-PCIs). Results: Percentages of PCI patients was higher in walking and lambda configurations than that in tuning fork. Mean diameter of bi-VAs and grade of BA lateral position were independent risk factors associated with PCI. Impact: Finding of this study will contribute to the stratification of stroke risk and significantly impact on clinical guidelines and treatment protocols for stroke prevention and management. Ultimately, this will be a step towards accurate diagnosis and treatment of PCI.