title: Percutaneous transluminal angioplasty and stenting of the vertebral artery ostium with balloon-mounted bare coronary stents.
abstract: BACKGROUND
  Vertebral artery ostial stenosis (VAOS) is one of the most frequent causes of posterior circulation stroke. Percutaneous angioplasty and stenting (PTAS) is one of the treatment modalities.
  
  
  METHODS
  This is a longitudinal observational study from September 2006 to February 2009, conducted at hospitals affiliated with the Shiraz University of Medical Sciences, Shiraz, southern Iran. The patient cohort included patients with posterior circulation stroke or transient ischemic attack (TIA) and more than 70% VAOS, and patients with asymptomatic VAOS of more than 70% and aplasia or total occlusion of the contralateral VA or subclavian artery. All the patients underwent PTAS with balloon-mounted bare coronary stents. Technical success, procedural complications, composite outcomes of death, stroke or TIA in the vertebrobasilar territory during the first 30 days, stroke or TIA in the vertebrobasilar territory, and restenosis during follow-up, were assessed.
  
  
  RESULTS
  During the study period, 81 patients (mean age 68 + 8.9 years, 63 (78%) males, 71 symptomatic and 18 asymptomatic) underwent the procedure. Technical success was achieved in 88 (99%) patients. Procedure-related complications, other than puncture site complications, were seen in two patients (2.2%). The composite outcome of death, stroke or TIA in the vertebrobasilar territory during the first 30 days was 1%. None of the patients had clinical recurrence or restenosis during the follow-up (mean follow-up 14 months).
  
  
  CONCLUSIONS
  Percutaneous transluminal angioplasty and stenting of the proximal VA was feasible and safe. The risk of restenosis should be analyzed in long-term studies with angiographic follow-up.
authors: Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Javad
authors: J
authors: Kojuri
authors: Mohammad Ali
authors: MA
authors: Ostovan
authors: Fatemeh
authors: F
authors: Maleki
authors: Mehrzad
authors: M
authors: Pourjafar
authors: Bahman
authors: B
authors: Varavipour
authors: Afshin
authors: A
authors: Borhani Haghighi
mesh_terms: D000368:Aged; D017130:Angioplasty; D015331:Cohort Studies; D005260:Female; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D015607:Stents; D020521:Stroke / Q000601:surgery; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000628:therapy