Doppler Ultrasonography for the Assessment of Proximal Vertebral Artery Stenosis

Objective: We examined the usefulness of Doppler ultrasonography for the diagnosis of severe stenosis of the proximal vertebral artery (VA). Case Presentations: We performed Doppler ultrasonography of the VA in patients diagnosed with cerebral ischemia of the posterior circulation. Incorporating the diagnostic criteria for severe stenosis at the origin of the internal carotid artery (maximum peak systolic flow velocity: ≥200 cm/sec, or acceleration time: ≥110 msec), patients were screened for proximal VA stenosis and cerebral angiography was conducted if they fulfilled the above criteria. In all six patients in whom proximal VA stenosis was suspected on ultrasonography, angiography confirmed severe stenosis, and endovascular treatment was performed. In five patients who underwent postoperative ultrasonography, an improvement of the stenosis was confirmed. Conclusion: Doppler ultrasonography is useful for the screening and postoperative assessment of proximal VA stenosis.