Multicenter study of safety in stenting for symptomatic vertebral artery origin stenosis: results from the Society of Vascular and Interventional Neurology Research Consortium.
OBJECTIVE
To assess the safety and efficacy of vertebral artery origin angioplasty and stenting for stroke prevention in a multicenter clinical experience.


METHODS
Patients with symptomatic vertebral artery origin stenosis (VAOS) were gathered from the Society of Vascular and Interventional Neurology Research Consortium. Demographic, clinical, and procedural data were collected. The main outcome measure was procedural and peri-procedural risks of stroke, transient ischemic attack (TIA), or death at 1 and 3 months. Logistic regression analysis was used to assess covariates associated with future restenosis.


RESULTS
A total of 148 patients were included with mean age of 66.2 ± 11.5; 74% men and 77% Caucasian. One patient (.8%) had a stroke at 1 month and 5 of 96 (5.2%) patients had TIA at 3 months. There were no immediate procedural events or deaths. The mean angiographic pre-treatment stenosis was 80.5 ± 12.7%, which was reduced to 5.3 ± 9.1% after stent deployment. Follow-up angiography showed 15.5% of patients had significant restenosis (≥50%). Predictors of restenosis included age (OR 3.08; 95% CI 1.01, 9.41) and smoking (OR 3.10; 95% CI 1.12, 8.64).


CONCLUSIONS
Endovascular intervention of VAOS is associated with low peri-procedural complication rates. Restenosis remains a concern; age and smoking predicted future restenosis.
Society of Vascular and Interventional Neurology Research Consortium at Saint Louis University, Department of Neurology and Psychiatry, Saint Louis, MO 63104. USA.
Randall C
RC
Edgell
Osama O
OO
Zaidat
Rishi
R
Gupta
Alex
A
Abou-Chebl
Italo
I
Linfante
Andrew
A
Xavier
Raul
R
Nogueira
Amer
A
Alshekhlee
Jundaid
J
Kalia
Vahid
V
Etezadi
Nima
N
Aghaebrahim
Tudor
T
Jovin
D000368:Aged; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D002533:Cerebral Angiography / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D020521:Stroke / Q000000981:diagnostic imaging / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*