الفهرس 
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Abstract
In the present study the aim was to study the outcome after vertebral artery stenting and/or balloon angioplasty and to determine the incidence of restenosis as a main challenging complication after stenting or angioplasty and to determine different risk factors responsible for that complication. to achieve this aim, data collected from patients underwent vertebral artery stenting or angioplasty over one year since 12/2017 till 12/2018,after applying this inclusion and exclusion criteria the study was conducted on 15 patients (M:F = 12:3), mean of age (63.33 ± 6.90) (symptomatic : asymptomatic = 11:4).
Inclusion criteria
1) Patients presented with posterior circulation ischemic stroke or TIA with angiographically evidence of Vertebral artery Stenosis more than 50 % in dominant artery.
2) Vertebral artery dissection.
3) Vasculitis affecting vertebral artery.
4) Patients undergo balloon dilatation and or stenting.
Exclusion criteria
1) Patients who have anterior circulation stroke.
2) Patients with tandem distal basilar and posterior cerebral artery Stenosis
Methods
1- Ethical approval and written informed consent from all the subjects.
2- Complete history taking from all patients including: age, sex, past medical history, presenting symptoms and family history of stroke.
4- Pre procedural complete neurological examination, NIHSS score estimation.
5- Laboratory investigations including renal function test, lipid profile, liver function test and ECG.
After procedure
All patients were followed up at 3 months and 6 months.
1- Follow up neurological examinations To detect any follow up complications and MRS estimation.
2- Ct angiography to detect restenosis.
In stent restenosis will be considered in case of recurrent artery stenosis with > 30 % luminal narrowing after exclusion of residual stenosis.
from the study we came out with the following results:
1- As regards the outcome after vertebral artery stenting and /or balloon angioplasty:
• No myocardial infarction or death occurred among the patients.
• One patient (6.7%) developed TIA during follow up period but no ischemic stroke developed in any patients.
2-As regards the incidence of restenosis:
• Only one patient (6.7%) developed restenosis of more than 50 % after balloon angioplasty during the follow up period.
3- As regards the risk factors responsible for restenosis
• Couldn’t be determined as only one patient developed restenosis 4-As regard the difference between the primary stenting in acute stroke management and elective stenting (extra-work)
• The difference was statistically insignificant as regard the incidence of TIA, stroke or restenosis.