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Diagnosis and management of vertebrobasilar insufficiency.
MedLine Citation:
PMID:  23378181     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Understanding the anatomical pathways and clinical presentations for VBI are of the utmost importance due to the potential mimics that may occur. After identification of the entity, imaging must be performed to identify the etiology. Distinguishing external compression of the vertebral artery from intrinsic vascular disease due to atherosclerosis or dissection is critical to aid the clinician in the therapeutic decision tree. Patients with an external compression due to an osteophyte may benefit from definitive surgical decompression and excision of the bony structure. Patients with extracranial disease of the vertebral artery who have failed maximal medical therapy may benefit from angioplasty and stenting which appears to carry a low morbidity. Extracranial vertebral artery dissections can be treated with medical therapy using anti-platelet agents or on occasion anti-coagulation. Rarely, endovascular options are required if a patient is having hemodynamic stroke or TIAs due to flow failure. In such circumstances, stenting and angioplasty may be considered. Intracranial atherosclerosis is best managed with maximal medical therapy due to the high rate of complications attributable to stenting and angioplasty.
Authors:
Aaron Stayman; Raul G Nogueira; Rishi Gupta
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in cardiovascular medicine     Volume:  15     ISSN:  1092-8464     ISO Abbreviation:  Curr Treat Options Cardiovasc Med     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-27     Completed Date:  2013-03-28     Revised Date:  2013-07-25    
Medline Journal Info:
Nlm Unique ID:  9815942     Medline TA:  Curr Treat Options Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  240-51     Citation Subset:  -    
Affiliation:
Emory University School of Medicine, Department of Neurology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, 49 Jesse Hill Jr. Drive, SE, Faculty Office Bldg. #393, Atlanta, GA, 30303, USA.
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