[Stent-assisted angioplasty and long-term results in atherosclerotic vertebral artery ostial stenosis].

OBJECTIVE

To evaluate the safety, feasibility and long-term results of stent-assisted angioplasty in atherosclerotic ostial stenosis of vertebral artery (VA).

METHODS

Forty one patients (48 lesions) with symptomatic cerebral ischemic events or stroke attributed to VA atherosclerotic ostial stenosis > or = 50% (NASCET method) found in digital subtraction angiography (DSA) were approached for consent to participate in the study. During the procedure, three cases used protection devices and three used drug-eluting stents.

RESULTS

Thirty seven of the patients were male and 4 female. Mean age was 63.4 years (range 36 - 80). Technical success was achieved in 97.9 % of the lesions. One suffered from a stroke that occurred within 30-days postprocedural. 37 patients were followed up for 22.4 months. The clinical follow-up outcomes showed that there were no lesion-related strokes and deaths, three appeared to have return of neurological symptoms (TIA). Among the 21 patients (26 lesions) who had angiography follow-up, re-stenosis (> or = 50%) was revealed in 9 patients (9 lesions) (34.6%). However, seven of these 9 patients remained asymptomatic.

CONCLUSIONS

Stent-assisted angioplasty for atherosclerotic ostial stenosis of VA is safe and feasible. It can prevent the lesion-related stroke, death and TIA recurrence. However, further studies are needed to clarify how to reduce the relatively high re-stenosis rate.