OBJECTIVE: To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results. MATERIALS AND METHODS: A total of 20 lesions in 20 patients underwent stenting of the VAOS using a self-expanding stent (Precise RX; Cordis Neurovascular, Miami Lakes, FL). Two patients were asymptomatic. We analyzed the technical success rate, causes of technical failure, occurrence of any vascular or neurological event, and the occurrence of any neurological abnormality or in-stent restenosis (ISR) seen on follow-up. The imaging follow-up was performed with Doppler ultrasound (DUS) as a primary screening modality. RESULTS: One instance of technical failure was caused by failure of the guidewire passage. The stent diameter was 5 mm, and post-stenting balloon dilatations were necessary in all cases. Stent misplacement requiring placement of an additional stent occurred in four cases. Following a 14.8 month average clinical follow-up time, two patients showed anterior circulation ischemia, which was not attributed to the VAOS we treated. Following a 13.7 month average DUS follow-up, five patients showed a mild degree of diffuse or focal intimal thickening in the stent lumen; however, none of the stenosis showed luminal loss of more than 50% and no stent fracture was noted. CONCLUSION: The use of self-expanding stents for treating VAOS was technically feasible and helped to improve artery patency during our limited follow-up interval.
OBJECTIVE: To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results. MATERIALS AND METHODS: A total of 20 lesions in 20 patients underwent stenting of the VAOS using a self-expanding stent (Precise RX; Cordis Neurovascular, Miami Lakes, FL). Two patients were asymptomatic. We analyzed the technical success rate, causes of technical failure, occurrence of any vascular or neurological event, and the occurrence of any neurological abnormality or in-stent restenosis (ISR) seen on follow-up. The imaging follow-up was performed with Doppler ultrasound (DUS) as a primary screening modality. RESULTS: One instance of technical failure was caused by failure of the guidewire passage. The stent diameter was 5 mm, and post-stenting balloon dilatations were necessary in all cases. Stent misplacement requiring placement of an additional stent occurred in four cases. Following a 14.8 month average clinical follow-up time, two patients showed anterior circulation ischemia, which was not attributed to the VAOS we treated. Following a 13.7 month average DUS follow-up, five patients showed a mild degree of diffuse or focal intimal thickening in the stent lumen; however, none of the stenosis showed luminal loss of more than 50% and no stent fracture was noted. CONCLUSION: The use of self-expanding stents for treating VAOS was technically feasible and helped to improve artery patency during our limited follow-up interval.
Authors: L R Caplan; P Amarenco; A Rosengart; E F Lafranchise; P A Teal; M Belkin; L D DeWitt; M S Pessin Journal: Neurology Date: 1992-08 Impact factor: 9.910
Authors: H D Chastain; M S Campbell; S Iyer; G S Roubin; J Vitek; A Mathur; N A Al-Mubarak; J B Terry; V Yates; K Kretzer; D Alred; C R Gomez Journal: J Neurosurg Date: 1999-10 Impact factor: 5.115
Authors: Louis R Caplan; Robert J Wityk; Thomas A Glass; Jorge Tapia; Ladislav Pazdera; Hui-Meng Chang; Phillip Teal; John F Dashe; Claudia J Chaves; Joan C Breen; Kostas Vemmos; Pierre Amarenco; Barbara Tettenborn; Megan Leary; Conrad Estol; L Dana Dewitt; Michael S Pessin Journal: Ann Neurol Date: 2004-09 Impact factor: 10.422