In the past 5 years we have investigated 29 patients with symptomatic basilar artery stenoses ( 14 cases) and occlusions ( 14) and a patent primitive trigeminal artery with thin-calibered basilar and vertebral arteries ( 1) using directional continuous-wave Doppler sonography of the vertebral arteries A total of 19 patients survived, and 17 of them were clinically and sonographically reexamined after 40 4 ± 15 8 months (mean ± SD) Among the 8 patients with basilar stenoses, 6
with no further transient ischemic attacks (TI As) in the interval exhibited an increase in the summed modified Pourcelot indices (relative end-diastolic flow velocities) of the vertebrals by 0 18 ± 0 16 ; the other 2 showed a decrease by 0 26 each, in 1 case temporally related to a TIA, in the 2nd case without further clinical deterioration. In the 8 survivors with basilar occlusions, 5 remained by sonographic criteria unchanged with summed modified Pourcelot indices of the vertebrals of 0 00, while 3 patients exhibited a slight increase in the summed modified Pourcelot indices of 0 13 + 0 03 While the difference between the outcome of subsets of patients treated with regimens of 30,000-40,000 units heparin/day or phenprocoumon and less radical drugs were statistically not significant, the former regimen appeared clinically more efficacious in preventing further deterioration in approximately twothirds of the patients affected Due to the potential recurrence of neurological symptoms, a treatment period with phenprocoumon of 6 months after discharge from hospital appears justified Due to these therapeutic efforts, approximately half of the patients initially affected survived with no or only a Offprint requests to: S Biedert * Herrn Prof Dr H Ganshirt anla Blich seiner Emeritierung in Dankbarkeit gewidmet mild neurological deficit Directional continuouswave Doppler sonography is, in our opinion, a reliable technique for examining the short and longterm changes in peripheral vascular resistance.