Use of self-expanding stents for the treatment of vertebral artery ostial stenosis: a single center experience.
OBJECTIVE
To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results.


METHODS
A total of 20 lesions in 20 patients underwent stenting of the VAOS using a self-expanding stent (Precise RX; Cordis Neurovascular, Miami Lakes, FL). Two patients were asymptomatic. We analyzed the technical success rate, causes of technical failure, occurrence of any vascular or neurological event, and the occurrence of any neurological abnormality or in-stent restenosis (ISR) seen on follow-up. The imaging follow-up was performed with Doppler ultrasound (DUS) as a primary screening modality.


RESULTS
One instance of technical failure was caused by failure of the guidewire passage. The stent diameter was 5 mm, and post-stenting balloon dilatations were necessary in all cases. Stent misplacement requiring placement of an additional stent occurred in four cases. Following a 14.8 month average clinical follow-up time, two patients showed anterior circulation ischemia, which was not attributed to the VAOS we treated. Following a 13.7 month average DUS follow-up, five patients showed a mild degree of diffuse or focal intimal thickening in the stent lumen; however, none of the stenosis showed luminal loss of more than 50% and no stent fracture was noted.


CONCLUSIONS
The use of self-expanding stents for treating VAOS was technically feasible and helped to improve artery patency during our limited follow-up interval.
Chung
Sun Young
SY
Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
Lee
Deok Hee
DH
Choi
Jin Woo
JW
Choi
Byung Se
BS
In
Hyun Sin
HS
Kim
Sun Mi
SM
Choi
Choong Gon
CG
Kim
Sang Joon
SJ
Suh
Dae Chul
DC
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D014654:Vascular Patency; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D014715:Vertebrobasilar Insufficiency / Q000628:therapy*