Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke Study (Veritas): Rationale and Design

Sepideh Amin-Hanjani; Linda Rose-Finnell; DeJuran Richardson; Sean Ruland; Dilip Pandey; Keith R Thulborn; David S Liebeskind; Gregory J Zipfel; Mitchell S. V Elkind; Jeffrey Kramer; Frank L Silver; Scott E Kasner; Louis R Caplan; Colin P Derdeyn; Philip B Gorelick; Fady T Charbel

doi:10.1111/j.1747-4949.2010.00528.x

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Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke Study (Veritas): Rationale and Design

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Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke Study (Veritas): Rationale and Design

Sepideh Amin-Hanjani, Linda Rose-Finnell, DeJuran Richardson, Sean Ruland, Dilip Pandey, Keith R Thulborn, David S Liebeskind, Gregory J Zipfel, Mitchell S. V Elkind, Jeffrey Kramer, …

International journal of stroke, Vol.5(6), pp.499-505

12/2010

DOI: 10.1111/j.1747-4949.2010.00528.x

PMCID: PMC3057649

PMID: 21050408

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Abstract

Background: Over one-third of ischaemic strokes occur in the posterior circulation, and a leading cause is atherosclerotic vertebrobasilar disease. Symptomatic vertebrobasilar disease carries a high annual recurrent stroke risk, averaging 10-15% per year. Endovascular angioplasty and stenting are increasingly used but carry risks, and the benefit remains unproven. Determining stroke predictors in this population is critical to identifying high-risk patients for future trials of intervention. Preliminary studies indicate that stroke risk in vertebrobasilar disease is strongly related to haemodynamic compromise, which can be measured noninvasively using quantitative magnetic resonance angiography. Methods/study design: The Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke (VERiTAS) study, a prospective multicentre NIH-funded observational study of symptomatic vertebrobasilar stenosis (≥50%) or occlusion, is designed to test the hypothesis that patients demonstrating compromised blood flow as assessed by quantitative magnetic resonance angiography are at higher stroke risk. The study will recruit 80 patients at six sites in North America over 4-years. Upon enrollment, subjects will undergo haemodynamic assessment with blinded quantitative magnetic resonance angiography to assess large vessel flow in the vertebrobasilar territory, and be prospectively designated as compromised or normal flow. Patients will be re-imaged with quantitative magnetic resonance angiography at 6-, 12-, and 24-months, and followed for 12-24-months for the primary end-point of stroke in the vertebrobasilar territory. Conclusion: The VERiTAS study is the first prospective study of haemodynamics and stroke risk in the posterior circulation. The results may impact the selection criteria for interventional candidates and also define a low-risk population in whom the risks of invasive interventions would be unnecessary.

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Title: Subtitle: Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke Study (Veritas): Rationale and Design
Creators: Sepideh Amin-Hanjani - Department of Neurosurgery, Neuropsychiatric Institute, University of Illinois at Chicago, Chicago, IL, USA
Linda Rose-Finnell - Department of Neurosurgery, Neuropsychiatric Institute, University of Illinois at Chicago, Chicago, IL, USA
DeJuran Richardson - Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA, Department of Mathematics & Computer Science, Lake Forest College, Lake Forest, IL, USA
Sean Ruland - Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
Dilip Pandey - Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
Keith R Thulborn - Department of Radiology, Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, USA
David S Liebeskind - Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
Gregory J Zipfel - Departments of Neurosurgery and Neurology, Washington University in St Louis, St Louis, MI, USA
Mitchell S. V Elkind - Departments of Neurology and Epidemiology, Columbia University, New York, NY, USA
Jeffrey Kramer - Department of Neurology, Mercy Hospital and Medical Center, Chicago, IL, USA
Frank L Silver - Department of Neurology, Toronto Western Hospital, University of Toronto, Toronto, Canada
Scott E Kasner - Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
Louis R Caplan - Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
Colin P Derdeyn - Departments of Neurosurgery and Neurology, Washington University in St Louis, St Louis, MI, USA, Mallinkrodt Institute of Radiology, Washington University in St Louis, St Louis, MI, USA
Philip B Gorelick - Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
Fady T Charbel - Department of Neurosurgery, Neuropsychiatric Institute, University of Illinois at Chicago, Chicago, IL, USA
Resource Type: Journal article
Publication Details: International journal of stroke, Vol.5(6), pp.499-505
DOI: 10.1111/j.1747-4949.2010.00528.x
PMID: 21050408
PMCID: PMC3057649
NLM abbreviation: Int J Stroke
ISSN: 1747-4930
eISSN: 1747-4949
Language: English
Date published: 12/2010
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020755702771

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