title: Endovascular treatment of symptomatic high-grade vertebral artery stenosis.
abstract: BACKGROUND
  The purpose of this study was to evaluate the initial and long-term results of endovascular treatment (EVT) in patients with symptomatic high-grade extracranial vertebral artery (VA) origin stenosis.
  
  
  METHODS
  From February 2001 to March 2013, 73 consecutive patients (33 men with a mean age of 61.7 ± 8.8 years) underwent EVT for symptomatic high-grade VA stenosis. Preoperative evaluation included Duplex ultrasonography and arteriography. After successful treatment, all patients were followed up at 1, 3, 6, and 12 months after the procedure and every 6 months thereafter.
  
  
  RESULTS
  Successful EVT of the VA stenosis was achieved in 68 patients (93.2%). All procedures were performed without use of cerebral protection. The early complication rate was 5.5%, which included one periprocedural transient ischemic attack, two hematomas at the puncture site, and one allergic reaction to the contrast agent. No in-hospital deaths occurred. During follow-up (mean, 44.3 ± 31.2 months; range, 2-144 months), the primary patency rates at 1, 3, 5, and 7 years were 98.4%, 87.3%, 87.3%, and 87.3%, respectively. Ultrasound Doppler controls during follow-up detected seven VA restenoses (10.3%). Univariate analysis failed to identify any variable predictive of long-term patency of successfully treated VA stenosis.
  
  
  CONCLUSIONS
  EVT of symptomatic VA origin stenosis is a safe and effective procedure associated with low risk and good long-term results, even without use of cerebral protection devices.
authors.affiliation: Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia; Belgrade University School of Medicine, Belgrade, Serbia.
authors.forename: Djordje
authors.initials: D
authors.lastname: Radak
authors.affiliation: Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia. Electronic address: sdrbabic@gmail.com.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Babic
authors.affiliation: Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia; Belgrade University School of Medicine, Belgrade, Serbia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Sagic
authors.affiliation: Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Tanaskovic
authors.affiliation: Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kovacevic
authors.affiliation: Institute for Cardiovascular Disease "Dedinje", Belgrade, Serbia.
authors.forename: Petar
authors.initials: P
authors.lastname: Otasevic
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Rancic
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery*
chemical_list: D003287:Contrast Media