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Angiography with stent placement with the proximal right VA resulted in resolution of symptoms. Symptoms of VB insufficiency may occur from bilateral VA disease, most often involving both proximal segments. Duplex ultrasound has high specificity but relatively low sensitivity for finding hemodynamically significant VA disease. Further imaging with CTA or magnetic resonance angiography (MRA) will help in identification of disease. As with this patient, invasive angiography with percutaneous stenting of the most significantly stenosed VA often results in resolution of symptoms of VB insufficiency.<\/jats:p>","DOI":"10.1111\/echo.14656","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T17:17:05Z","timestamp":1587489425000},"page":"784-787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Six\u2010year history of intermittent symptomatic bilateral vertebral artery stenosis: Imaging and therapeutic intervention"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5842-5672","authenticated-orcid":false,"given":"Christian K.","family":"Kerut","sequence":"first","affiliation":[{"name":"Franklin College of Arts and Sciences University of Georgia Athens 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