Drug-eluting stent for the treatment of symptomatic vertebral origin stenosis: Long-term results.
Atherosclerotic stenosis originating from the vertebral artery (VA) is a well-known cause of stroke in the posterior circulation. Stent-assisted angioplasty using a bare metal stent is safe but used in a limited number of patients due to high rates of in-stent restenosis (ISR). A drug-eluting stent (DES) is an alternative for reducing ISR after stenting for atherosclerotic stenosis. We report the technical feasibility and mid to long-term clinical and angiographic outcomes after stenting with a DES in vertebral origin stenosis. This retrospective study included 47 consecutive patients treated with DES for vertebral origin stenosis. The demographics, indications for treatment, procedural technique, clinical and radiographical follow-up results were reviewed. The technical success rate was 100% without any complications. Postprocedure residual stenosis was 8.6% (range=0-12%). All patients were followed up clinically for a mean of 28.3 months (range=12-68 months), and two patients (4.2%) had recurrent stroke in stented-vessel territories at 5 and 17 months after the procedure, respectively. Digital subtraction angiography was performed at follow-up in 38 patients (80.9%) at a mean of 16.3 months (range=6-48 months) and showed two patients with ISR (5.3%) and four stent fractures (10.5%). One asymptomatic ISR was related to stent fracture. DES for vertebral origin stenosis are safe and effective with an acceptable lower ISR rate. However, stent fracture may be a potential complication and requires long-term follow-up.
Chen
Xinpu
X
Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China.
Huang
Qinghai
Q
Hong
Bo
B
Zhang
Yongwei
Y
Xu
Yi
Y
Liu
Jianmin
J
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*