OBJECTIVES: This study aims to determine safety and efficacy of different stent types for extracranial vertebral artery stenting (EVAS) at a single-center institution. BACKGROUND: Although endovascular revascularization techniques are well established for a variety of arterial vessel territories, its role within the vertebrobasilar system is less well defined. METHODS: We retrospectively analyzed all EVAS procedures performed at our institution between 1997 and 2012. RESULTS: A total of 35 EVAS procedures were attempted in 35 patients with symptomatic occlusive extracranial vertebral artery (EVA) disease. Carotid self-expanding bare-metal stents (BMS-SE; n = 18), coronary balloon-expandable bare-metal stents (BMS-BE; n = 7) or drug-eluting stents (DES-BE; n = 16) were used according to physician's choice. The overall technical and clinical success rate was 100 and 94 %, respectively. Periprocedural complications included one death 14 days after intervention due to complications of initial stroke and 3 (9 %) patients with access site complications. Follow-up after a median of 18 ± 21 months yielded an overall in-stent restenosis rate of 23 % and a recurring clinical symptoms rate of 20 % whereas both endpoints were closely associated as 83 % of patients with recurring symptoms showed significant restenosis. Concerning the stent type, BMS-SE were associated with a significant higher in-stent restenosis rate compared to balloon-expandable stents (p = 0.012), and although not statistically significant, there was a clear trend towards a lower in-stent restenosis rate in drug-eluting compared to bare-metal stents (p = 0.068). CONCLUSIONS: In patients with symptomatic extracranial vertebral artery disease, stenting is a safe and effective treatment option whereas balloon-expandable stents, and particularly drug-eluting stents, are superior to self-expanding stents.
OBJECTIVES: This study aims to determine safety and efficacy of different stent types for extracranial vertebral artery stenting (EVAS) at a single-center institution. BACKGROUND: Although endovascular revascularization techniques are well established for a variety of arterial vessel territories, its role within the vertebrobasilar system is less well defined. METHODS: We retrospectively analyzed all EVAS procedures performed at our institution between 1997 and 2012. RESULTS: A total of 35 EVAS procedures were attempted in 35 patients with symptomatic occlusive extracranial vertebral artery (EVA) disease. Carotid self-expanding bare-metal stents (BMS-SE; n = 18), coronary balloon-expandable bare-metal stents (BMS-BE; n = 7) or drug-eluting stents (DES-BE; n = 16) were used according to physician's choice. The overall technical and clinical success rate was 100 and 94 %, respectively. Periprocedural complications included one death 14 days after intervention due to complications of initial stroke and 3 (9 %) patients with access site complications. Follow-up after a median of 18 ± 21 months yielded an overall in-stent restenosis rate of 23 % and a recurring clinical symptoms rate of 20 % whereas both endpoints were closely associated as 83 % of patients with recurring symptoms showed significant restenosis. Concerning the stent type, BMS-SE were associated with a significant higher in-stent restenosis rate compared to balloon-expandable stents (p = 0.012), and although not statistically significant, there was a clear trend towards a lower in-stent restenosis rate in drug-eluting compared to bare-metal stents (p = 0.068). CONCLUSIONS: In patients with symptomatic extracranial vertebral artery disease, stenting is a safe and effective treatment option whereas balloon-expandable stents, and particularly drug-eluting stents, are superior to self-expanding stents.
Authors: Rishi Gupta; Firas Al-Ali; Ajith J Thomas; Michael B Horowitz; Thomas Barrow; Nirav A Vora; Ken Uchino; Maxim D Hammer; Lawerence R Wechsler; Tudor G Jovin Journal: Stroke Date: 2006-09-07 Impact factor: 7.914
Authors: Z Vajda; E Miloslavski; T Güthe; S Fischer; G Albes; A Heuschmid; H Henkes Journal: AJNR Am J Neuroradiol Date: 2009-09-03 Impact factor: 3.825
Authors: A Compter; H B van der Worp; W J Schonewille; J A Vos; A Algra; T H Lo; W P Th M Mali; F L Moll; L J Kappelle Journal: Trials Date: 2008-11-24 Impact factor: 2.279
Authors: Damian R Maciejewski; Piotr Pieniazek; Lukasz Tekieli; Piotr Paluszek; Tadeusz Przewlocki; Tomasz Tomaszewski; Roman Machnik; Mariusz Trystula; Jacek Legutko; Anna Kablak-Ziembicka Journal: Postepy Kardiol Interwencyjnej Date: 2019-09-18 Impact factor: 1.426