Inclusion/Exclusion Criteria

Inclusion/Exclusion Criteria

Inclusion Criteria:

  • Symptomatic patients (TIA or stroke) in the vertebrobasilar territory.
  • Conventional or CT angiographic demonstration ofgreater than or equal50% stenosis or occlusion of extracranial or intracranial vertebral, or basilar, arteries.
  • Symptoms within 60 days of enrollment.
  • Age 18 and above.
  • Able to provide informed consent.

Exclusion Criteria:

1. Neurologic criteria:

  • Major disabling stroke prohibiting the ability to return for follow-up assessment.
  • Any neurological disease which would confound follow-up assessment.

2. Medical criteria

  • Any severe co-morbidity condition with less than 12 month life expectancy.
  • Known cardiac disease associated with cardioembolic risk specifically atrial fibrillation, prosthetic valves, endocarditis, left atrial/ventricular thrombus, cardiomyopathy with EF < 25%, cardiac myxoma.
  • Blood dyscrasias, specifically polycythemia vera, essential thrombocytosis, sickle cell disease.

3. Disease criteria

  • Non-atherosclerotic disease vertebrobasilar disease including dissection, fibromuscular dysplasia, vasculitis, radiation induced vasculopathy.
  • Unilateral vertebral stenosis or occlusion.

4. Patient criteria

  • Unable or unwilling to undergo MRI.
  • Unable to undergo cerebral angiography.
  • Pregnancy.
  • Concurrent participation in an interventional trial for treatment of vertebrobasilar disease.
Renal dysfunction will be exclusionary if it precludes angiography.