Percutaneous Interventional Treatment of Extracranial Vertebral Artery Stenosis with Coronary Stents.
10.3349/ymj.2004.45.4.629
- Author:
Young Guk KO
1
;
Sungha PARK
;
Jong Youn KIM
;
Pil Ki MIN
;
Eui Young CHOI
;
Jae Hun JUNG
;
Boyoung JOUNG
;
Donghoon CHOI
;
Yangsoo JANG
;
Won Heum SHIM
Author Information
1. Cardiology Division, Yonsei Cardiovascular Center, Research Institute, Yonsei University College of Medicine, Seoul, Korea. whshim@yumc.yonsei.ac.kr
- Publication Type:Original Article ; Clinical Trial
- Keywords:
Vertebral artery;
vertebrobasilar artery insufficiency;
percutaneous transluminal angioplasty;
stenting
- MeSH:
Adult;
Aged;
Angiography;
*Angioplasty, Balloon;
Female;
Follow-Up Studies;
Humans;
Male;
Middle Aged;
*Stents;
Treatment Outcome;
Vertebrobasilar Insufficiency/diagnosis/*therapy
- From:Yonsei Medical Journal
2004;45(4):629-634
- CountryRepublic of Korea
- Language:English
-
Abstract:
Stenosis of extracranial vertebral artery (VA) is not an infrequent lesion, and it can pose a significant clinical problem. However, the standard treatment for a significant VA stenosis has still not been established. Here in this study, we report our experiences of VA stenting in 25 patients (age 56.2 +/-15.2 years, male 76%). The patients had comorbidities as follows: DM (36%), hypertension (64%), Takayasu's (12%) and Behcet's diseases (4%). There were combined involvement of other vessels such as the coronary artery (72%), carotid artery (36%), subclavian artery (32%) and the contralateral vertebral artery (24%). Indications for stenting were prior stroke or symptoms related to vertebrobasilar ischemia in 11 patients, and an asymptomatic but angiographically significant stenosis (> 70% stenosis) in 14 patients. Twenty-three balloon-expandable stents and two self-expandable stents were deployed. A drug-eluting coronary stent and distal balloon protection device were each used in one case. A technically successful procedure was achieved in all patients. The baseline reference diameter was 4.7 +/-1.3 mm, minimal luminal diameter (MLD) 1.0 +/-0.6 mm (diameter stenosis 77.8 +/-12.5%) and lesion length 6.4 +/-3.9 mm. After stenting and adjuvant dilation, the MLD was increased to 4.5 +/-0.9 mm (diameter stenosis 3.1 +/-17.9%). There were no procedure-related complications. During the further follow-up period of 25 (3-49) months, no stroke or death occurred. Restenosis was observed in 4 (30.8%) of 13 eligible patients. In conclusion, VA stenting is feasible with a high degree of technical success, and this treatment is associated with a relatively low incidence of procedure-related complications. However, a relative high rate of in-stent restenosis remains as a problem to be resolved.
