A 74 year old man developed drop attacks and was found to harbor severe stenosis of the left vertebral artery at the vessel origin from the left subclavian artery (top left image, black arrow). Under light sedation, stent-supported angioplasty was performed using a 4 mm diameter stainless steel stent(top right and lower left images, white arrows). The vessel was easily dilated.and the patient remains asymptomatic taking only aspirin and Lipitor. The intracranial vessels are comparitviely normal in appearance. Although the data on the benefits of treatment for vertebral artery stenosis is more limited than that for carotid artery disease, many patients demonstrate remarkable improvement following stent-angioplasty. By comparison, treatment with open surgery for this condition has significantly higher risks of major morbidity. Follow-up evaluation is usually performed with ultrasound, MR-angiography, or CT-angiography.