title: Treatment of vertebral artery origin stenosis with anti-proliferative drug-eluting stents.
abstract: 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.
authors.affiliation: Department of Surgery, Division of Neurosurgery, St. Louis University, St. Louis, MO 63110, USA. randall.edgell@gmail.com
authors.forename: Randall C
authors.initials: RC
authors.lastname: Edgell
authors.forename: Dileep R
authors.initials: DR
authors.lastname: Yavagal
authors.forename: Doniel
authors.initials: D
authors.lastname: Drazin
authors.forename: Raul
authors.initials: R
authors.lastname: Olivera
authors.forename: Alan S
authors.initials: AS
authors.lastname: Boulos
mesh_terms: 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*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus