[Management of elderly patients with symptomatic vertebrobasilar insufficiency].
OBJECTIVE
To evaluate the feasibility, safety and short-term efficacy of stent-assisted angioplasty and/or drug therapy for elderly patients with symptomatic vertebrobasilar insufficiency.


METHODS
Elderly patients (> or = 60 years old) with symptomatic vertebrobasilar stenosis (> or = 50%) demonstrated by cerebral angiography were treated with drug therapy and some with endovascular stenting further from April 2001 to June 2006. The clinical, imaging, intervention and follow-up data were collected and analyzed.


RESULTS
Eighty-one elderly patients were chosen for study, including 68 males and 13 females. The mean age is 70 years (60 - 87 years); stroke rate of 4.9% (4/81) and stroke-related mortality rate of 2.5% (2/81) were found in this group during hospitalization and follow-up (mean 28.1 months), and symptoms resolved or improved clinically in 66 (81.5%). Fifty-two balloon expandable stents were placed in 48 (59.3%) patients of this group with a technical success rate of 98.1% and the mean degree of stenosis was reduced from (82.4 +/- 13.1)% to (6.4 +/- 3.2)% (t = 22.4, P = 0.00).


CONCLUSIONS
Appropriate management including endovascular stenting and/or drug therapy may improve short-term outcomes of elderly patients with symptomatic vertebrobasilar insufficiency; meanwhile, stent-assisted angioplasty is technically feasible and relatively safe.
Lu
Jun
J
Department of Neurosurgery, Beijing Hospital, Beijing 100730, China.
Wang
Da-Ming
DM
Chen
Hai-Bo
HB
Liu
Jia-Chun
JC
Liu
Fang
F
Jiang
Hong-Zhi
HZ
Li
Jin
J
Wang
Li-Jun
LJ
Gong
Tao
T
Jiang
Xue-Li
XL
Zhai
Le-Le
LL
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy / Q000628:therapy*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors