Treatable lesions demonstrated on vertebral angiography for posterior circulation ischaemic events.

Angiography after a posterior circulation ischaemic event is often not considered because of the perception that it will not alter patient management. We identified 53 patients investigated with vertebral angiography over a 5 year period. This was significantly abnormal in 32 patients (60%). Five (9%) had vertebral artery dissections, nine (17%) had unilateral vertebral artery occlusion, two had a basilar artery disease. 16 (30%) had vertebral artery stenosis. 12 stenoses were considered suitable for percutaneous transluminal angioplasty (23%). 11 patients were anticoagulated (21%). There was no significant correlation between clinical features, site of infarct or the presence of carotid stenosis that would have allowed the prediction of the findings in the posterior circulation. Our results indicate that using vertebral angiography to investigate posterior circulation ischaemia will identify a significant number of potentially treatable lesions.