Moufarrij N A, Little J R, Furlan A J, Leatherman J R, Williams G W
Stroke. 1986 Sep-Oct;17(5):938-42. doi: 10.1161/01.str.17.5.938.
Forty-four patients with greater than or equal to 50% stenosis of a distal vertebral artery (VA) and/or basilar artery (BA) were followed up for an average of 6.1 years. Angiography was performed for definite vertebrobasilar (VB) transient ischemic attacks (TIA) in 19 (43%), for VB infarcts in 13 (30%) and for non localizing symptoms in 12 (27%). Stenosis in the BA with or without VA involvement was present in 28 patients (64%), while 16 patients (36%) had occlusive disease in one or both distal VA sparing the BA. In follow up, 7 patients (16%) had definite VB TIA and 3 patients had possible VB TIA. Eight patients (18%) sustained a stroke, 5 of which were in the VB territory. The observed stroke rate was 17 times the expected rate for a matched normal population. Eight patients died during follow up, three patients due to stroke (2 brainstem infarctions, one intraventricular hemorrhage). The observed 5 year survival rate was 78% compared to 90% in a matched normal population. In comparing this data with our previous study of 93 patients with proximal VA occlusive disease, distal VB occlusive disease appears to carry a higher risk for brainstem ischemia.
44例椎动脉（VA）远端和/或基底动脉（BA）狭窄程度大于或等于50%的患者平均随访6.1年。19例（43%）因明确的椎基底动脉（VB）短暂性脑缺血发作（TIA）、13例（30%）因VB梗死、12例（27%）因无定位症状而进行血管造影。28例患者（64%）存在BA狭窄，伴或不伴有VA受累，而16例患者（36%）在一条或两条VA远端存在闭塞性病变，BA未受累。随访期间，7例患者（16%）发生明确的VB TIA，3例患者可能发生VB TIA。8例患者（18%）发生卒中，其中5例位于VB供血区。观察到的卒中发生率是匹配正常人群预期发生率的17倍。8例患者在随访期间死亡，3例死于卒中（2例脑干梗死，1例脑室内出血）。观察到的5年生存率为78%，而匹配正常人群为90%。将该数据与我们之前对93例近端VA闭塞性疾病患者的研究进行比较，远端VB闭塞性疾病似乎对脑干缺血具有更高的风险。
