Frequency and Predictors of Ultrasound-Detected Extracranial Vertebral Artery Stenosis in a Sample of Non-Western Population

Area of Science:

• Vascular Neurology
• Neurosonology
• Epidemiology

Background:

• Extracranial vertebral artery (VA) stenosis is a significant cause of posterior circulation ischemic events but is understudied, especially in Egyptian populations.
• Ethnic variations in VA stenosis prevalence suggest the need for regional investigations.

Purpose of the Study:

• To determine the frequency and identify predictors of extracranial VA stenosis in Egyptian patients.
• To compare the prevalence of VA stenosis in Egyptian patients with existing Western cohort data.

Main Methods:

• A cohort of 528 patients referred for neurovascular ultrasonography was studied.
• Extracranial VA stenosis was diagnosed and graded using ultrasound.
• Multivariate logistic regression analysis was employed to identify predictive factors for significant stenosis.

Main Results:

• Significant extracranial VA stenosis (≥50%) was identified in 10.4% of patients with posterior circulation ischemic events and 4.2% of those without (p=0.01).
• Carotid atherosclerosis was significantly more prevalent in patients with VA stenosis (82.1% vs. 47.6%, p<0.001).
• Predictors for significant VA stenosis included age >60 years, significant common/internal carotid artery stenosis, and posterior circulation ischemic events.

Conclusions:

• The prevalence of extracranial VA stenosis appears lower in Egyptians compared to Western cohorts.
• In patients with carotid atherosclerosis or significant carotid stenosis and/or posterior circulation events, thorough VA ultrasound is recommended to detect potential underlying extracranial VA stenosis.