[Endovascular treatment of vertebral artery origin stenosis in high risk patients].
OBJECTIVE
Atherosclerotic stenosis of the vertebrobasilar system most commonly occurs at the vertebral artery origin. Stenting of these stenotic lesions in combination with antithrombotics with or without anticoagulants is a safe and effective treatment method. The purpose of this study is to present the results of vertebral artery origin stenting in 14 high-risk patients.


METHODS
Significant vertebral artery origin stenosis was treated with primary stenting in 14 patients, aged between 58 and 74 years (mean, 66+/-5.3 years). Eleven patients were male, and three were female. Vertebral artery stenosis was detected in eight patients prior to coronary artery surgery, and in six patients after a posterior system stroke or during evaluation of a vertebrobasilar insufficiency. All stenosis were successfully treated with stent placement. Except one patient who had a left posterior cerebral artery infarction, all patients had an uneventful procedure without any complication. Third-month and sixth-month clinical and color Doppler follow-up examinations were available in ten patients, and 12th-month control angiography performed in three patients did not show stent restenosis. None of the patients had new neurologic deficit during the follow-up.


CONCLUSIONS
Vertebral artery origin stenoses are one of the most common causes of vertebrobasilar stroke. In the presence of concomitant cerebral artery stenosis or systemic disorders, patients are under high risk even if they are on medical therapy. Primary stenting combined with medical treatment is a safe and effective treatment modality.
Başkent Universitesi Adana Uygulama ve Araştirma Hastanesi, Radyoloji Kliniği, Adana, Turkey.
Osman
O
Kizilkiliç
Levent
L
Oğuzkurt
Tülin
T
Yildirim
Fahri
F
Tercan
Başak
B
Karakurum
Sibel
S
Karaca
Semih
S
Giray
Zülfikar
Z
Arlier
D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*