Right Vertebral Artery Stenosis with Left Hemispheric TIA: A Perplexing Etiology
Charles Hartranft*, Seth Noland, Aaron Kulwicki and Thomas Hartranft
Department of Surgery, Mount Carmel Health System, Columbus, Ohio, USA
- *Corresponding Author:
- Charles Hartranft
Department of Surgery
Mount Carmel Health System
793 West State St, OH 43222
E-mail: [email protected]
Received Date: June 12, 2014; Accepted Date: July 21, 2014; Published Date: July 23, 2014
Citation: Hartranft C, Noland S, Kulwicki A, Hartranft T (2014) Right Vertebral Artery Stenosis with Left Hemispheric TIA: A Perplexing Etiology. J Vasc Med Surg 2:144. doi:10.4172/2329-6925.1000144
Copyright: © 2014 Hartranft C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A 59-year-old female presented with symptoms concerning for left hemispheric transient ischemic attacks. Multiple imaging modalities confirmed the presence of acute left sided cerebral infarcts along with complete left internal carotid artery occlusion. Following discharge on appropriate medical therapy, the patient represented weeks later with similar complaints. Angiography confirmed left internal carotid artery occlusion and identified a right vertebral artery supplying the entire contralateral hemisphere. A segment of severe stenosis at the vertebral artery origin was identified and stented. Post-operatively, the patient recovered well and was discharged home without significant neurological deficits. During follow-up, in-stent restenosis developed at 7 months requiring additional intervention with balloon angioplasty and re-stenting. To date the patient suffers no significant neurologic deficits, is maintained on maximal medical therapy, and continues follow up with serial exams and ultrasound imaging.