Drug-eluting stents for the treatment of vertebral artery origin stenosis.
OBJECTIVE
To present our experience with the use of drug-eluting stents (DES) in patients with symptomatic vertebral artery ostium stenosis (VAOS).


METHODS
Between 2003 and 2008, 28 consecutive patients (17 men; mean age 66 years) with symptomatic extracranial vertebral artery stenosis were treated with a paclitaxel-eluting stent. All patients were prospectively scheduled for serial clinical, duplex, and angiographic follow-up to identify restenosis.


RESULTS
After stent implantation, the mean stenosis was reduced from 68% to 9%. There were no periprocedural neurological complications. After a mean follow-up of 16 months (range 5-41), no strokes, worsening of symptoms, or deaths occurred. Angiographic restenosis >50% was seen in 6 (21.4%) patients. Restenosis occurred significantly more often in patients with an ipsilateral subclavian artery stenosis (p = 0.01). Radiography during follow-up angiography revealed stent fracture in 1 patient and stent compression/kinking in 11 (39%) of the patients. Stent compression and recoil, not intimal hyperplasia, were the major contributing factors to restenosis.


CONCLUSIONS
Compared to the restenosis rate of bare metal stents reported in the literature, DES seems to be superior for the treatment of VAOS. However, stent compression and recoil are relevant problems contributing to restenosis. Further improvement of the materials for the interventional treatment of VAOS seems necessary.
Werner
Martin
M
1 Department of Medicine I-Angiology/Cardiology and, Park Hospital Leipzig, Germany.
Bräunlich
Sven
S
Ulrich
Matthias
M
Bausback
Yvonne
Y
Schuster
Johannes
J
Lukhaup
Anina
A
Botsios
Spiridon
S
Scheinert
Dierk
D
Schmidt
Andrej
A
D000368:Aged; D017130:Angioplasty; D015331:Cohort Studies; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
D050257:Tubulin Modulators; D017239:Paclitaxel