Megan Thompson
Clinical and Radiographic Significance of
High Resistive Appearance of the
Vertebral Artery on Carotid Duplex
Ultrasound

SchoolEdison High School • Milan, Ohio

ProgramScience Internship

MentorHeather Gornik, MD, MHS

DepartmentVascular Medicine & Laboratory, Cleveland Clinic

Research: Clinical and Radiographic Significance of High Resistive Appearance of the Vertebral Artery on Carotid Duplex Ultrasound

Hypothesis: The two vertebral arteries comprising the basilar artery enter the Circle of Willis, supplying blood to the posterior part of the brain. When vertebrobasilar stenosis or occlusion is evident, symptoms include motor deficits, abnormal eye movements, gait abnormalities, and cerebellar dysfunction. The hypothesis of this study is that qualitative “high resistive” appearance of the vertebral artery waveform on carotid duplex ultrasound predicts distal vertebral and/or basilar disease on an angiographic imaging study.

Methodology: The IRB-approved Cleveland Clinic Vascular Lab database was queried for all carotid duplex ultrasound examinations performed between 2005 and 2007. Studies were identified with interpretation of a “high resistive” signal in one or both vertebral arteries.

Outcomes: 38% of the cases exhibited no abnormal findings, 27% of the imaging cases had a congenitally diminutive vertebral artery, and 36% of the imaging cases demonstrated some kind of vertebral or basilar artery occlusive disease. In this study, disease was found in many cases that had a carotid duplex ultrasound demonstrating a “high resistive” vertebral artery. Patients found to have a high resistive signal during their carotid duplex ultrasound should be evaluated as to whether a neuroimaging study is indicated.

Interpretations

Quartet of Towers by Alyis Freeman

All Clogged Up by Jimmie Beres