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"Use of NOVA/Quantitative Magnetic Resonance Angiography to Stratify Stroke Risk in Symptomatic Vertebrobasilar Disease ", by Sepideh Amin-Hanjani, et. al., has been published in the American Heart Association journal, Stroke, June 2005.

Dr. Hanjani and her colleagues have developed the first flow based algorithm to guide patient management for patients with vertebrobasilar disease (VBD).

Up to 30% of all strokes involve the posterior circulation. One challenge every clinician faces is weighing the benefits and risks of treatment. Is the concern great enough to warrant intervention and if so, can it be drug therapy alone or is surgery necessary?

The authors sought to determine if quantitative blood flow measurements with NOVA could separate those patients at high risk for stroke from those at lower risk for whom drug therapy alone would be appropriate. The patients' arterial blood flow was measured with NOVA and compared to the normal ranges in a healthy population. Patients with greater than 20% reduction in their basilar and posterior cerebral arteries as compared to the normal range were designated as having low flow according to the algorithm.

Fifty patients diagnosed with symptomatic VBD underwent NOVA QMRA flow studies. All patients had >50% vessel stenosis and based on traditional criteria would have been considered for surgery or intervention. According to the NOVA algorithm, 66% of these patients (33/50) were found to have normal flow and were given only drug therapy. The stroke free survival in this group was 100% at 2 years.

The study provides evidence that patients at risk of stroke from VBD can be managed according to a flow based algorithm. Those patients found to have normal flow can avoid surgery, resulting in fewer complications, improved outcomes and lower health care costs.