Treatment of vertebral artery origin stenosis with anti-proliferative drug-eluting stents.
BACKGROUND
Vertebral artery origin stenosis is a known cause of stroke that is treatable with angioplasty and stenting. Previous studies have demonstrated that this technique is safe but is limited by high rates of in-stent stenosis. Anti-proliferative drug-eluting stents are an alternative for reducing in-stent stenosis at the vertebral artery origin.


METHODS
This retrospective study included five consecutive patients treated with anti-proliferative drug-eluting stents. The patients' demographics, indications for treatment, procedural technique, and clinical and radiographic follow-up are presented along with a review of the literature.


RESULTS
No peri-procedural complications occurred. One patient had a transient ischemic attack (TIA) during the follow-up period. No patients had hemodynamically significant (>50%) in-stent stenosis at follow-up. Among the 287 cases reported in the literature, there were two strokes (.7%), four TIAs (1.4%), and no procedurally related deaths. Among patients undergoing angiographic follow-up, 26% were found to have >50% in-stent stenosis.


CONCLUSIONS
Anti-proliferative drug-eluting stents hold promise for reducing in-stent stenosis at the vertebral artery origin.
Edgell
Randall C
RC
Department of Surgery, Division of Neurosurgery, St. Louis University, St. Louis, MO 63110, USA. randall.edgell@gmail.com
Yavagal
Dileep R
DR
Drazin
Doniel
D
Olivera
Raul
R
Boulos
Alan S
AS
D000368:Aged; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000628:therapy*
D007166:Immunosuppressive Agents; D020123:Sirolimus