Angioplasty or stenting of extra- and intracranial vertebral artery stenoses.
OBJECTIVE
To determine the feasibility and safety of angioplasty or angioplasty and stenting of extra- and intracranial vertebral artery (VA) stenosis.


METHODS
In 16 consecutive patients (9 men, 7 women; mean age 61 years, range 49-74 years) 16 stenotic VAs were treated with angioplasty or angioplasty and stenting. Eleven stenoses were localized in V1 segment, 1 stenosis in V2 segment and 4 stenoses in V4 segment of VA. Fourteen VA stenoses were symptomatic, 2 asymptomatic. The etiology of the stenoses was atherosclerotic in all cases.


RESULTS
Angioplasty was performed in 8 of 11 V1 and 2 of 4 V4 segments of the VA. In 3 of 11 V1 segments and 2 of 4 V4 segments of the VA we combined angioplasty with stenting. The procedures were successfully performed in 14 of 16 VAs (87%). Complications were asymptomatic vessel dissection resulting in vessel occlusion in 1 of 11 V1 segments and asymptomatic vessel dissection in 2 of 4 V4 segments of the VA. One patient died in the 24-hr period after the procedure because of subarachnoid hemorrhage as a complication following vessel perforation of the treated V4 segment.


CONCLUSIONS
Angioplasty or angioplasty and stenting of extracranial VA stenoses can be performed with a high technical success rate and a low complication rate. In intracranial VA stenosis the procedure is technically feasible but complications can be life-threatening. The durability and procedural complication rates of primary stenting without using predilation in extra- and intracranial VA stenosis should be defined in the future.
Hauth
Elke A M
EA
Department of Radiology and Interventional Radiology, University Hospital Essen, Essen, Germany.
Gissler
H Martin
HM
Drescher
Robert
R
Jansen
Christian
C
Jaeger
Horst J
HJ
Mathias
Klaus D
KD
D000368:Aged; D000800:Angioplasty, Balloon; D019917:Blood Vessel Prosthesis Implantation; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000601:surgery; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*