Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis.

BACKGROUND Surgery to the vertebrobasilar region is difficult and not considered in most centres. Furthermore, the basilar artery, with its penetrating branches supplying the brain stem, is likely to be extremely hazardous to dilate. OBJECTIVES The objective of this review was to assess the effect of vertebral artery percutaneous transluminal angioplasty combined with medical care, compared to medical care alone, in people with vertebrobasilar artery disease. SEARCH STRATEGY We searched the Cochrane Stroke Groups trials register (to August 1997). We contacted researchers in the field and balloon catheter manufacturers. SELECTION CRITERIA Randomised trials of vertebral percutaneous transluminal angioplasty (with or without stenting) combined with best medical therapy, compared with best medical therapy alone, in people with symptomatic vertebral artery stenosis. DATA COLLECTION AND ANALYSIS Two reviewers independently applied the inclusion criteria. MAIN RESULTS No completed trials were found. One trial is underway, although few patients with vertebrobasilar disease have been recruited. REVIEWER'S CONCLUSIONS There is no evidence as yet to assess the effects of percutaneous transluminal angioplasty for vertebral artery stenosis.