Broussalis E, Kunz A B, Luthringshausen G, Klein S, McCoy M R, Trinka E, Killer-Oberpfalzer M
Department of Neurology, Paracelsus Medical University, Christian Doppler Klinik, Salzburg, Austria.
Interv Neuroradiol. 2011 Sep;17(3):316-22. doi: 10.1177/159101991101700306. Epub 2011 Oct 17.
Atherosclerotic stenosis of vertebral artery (VA) origin exceeding 70% severity accounts for one third of all vertebrobasilar strokes. For a period of one year the results of endovascular treatment of VA stenosis with the new Pharos stent device were assessed.Twenty-two patients with symptomatic VA stenosis were treated with the Pharos stent. Clinical status and stenosis grade were documented before treatment and 24 hours, one, three and twelve months after treatment via ultrasound and magnetic resonance tomography.All procedures proved to be technically successful without the occurrence of intra-procedural complications. During the observation period of more than one year, 55% of patients were documented with a mean stenosis degree of 60%: two (10%) of these patients showed a residual stenosis after angioplasty and nine patients (45%) an in-stent restenosis, whereas only two patients were documented with a hemodynamically relevant in-stent restenosis of 80%. These two patients were retreated with balloon dilatation. None of the patients showed neurological deterioration or new abnormalities at magnetic resonance tomography examination. Neither VA occlusion nor restenosis of the contralateral VA negatively affected the clinical outcome. An in-stent restenosis was developed by more female than male patients.VA origin stenting with the Pharos stent device is an effective treatment of stenosis. The good clinical results compared to the high restenosis rates have to be examined in further studies. Pin particular, it has to be determined whether the Pharos stent allows the vessel time for collateralization, whether double antiplatelet treatment prevents recurrent cerebrovascular events or whether merely the low restenosis degree is causative for the clinical outcome.
椎动脉（VA）起始部动脉粥样硬化狭窄程度超过70%占所有椎基底动脉卒中的三分之一。对使用新型Pharos支架装置进行椎动脉狭窄血管内治疗的结果进行了为期一年的评估。22例有症状的椎动脉狭窄患者接受了Pharos支架治疗。通过超声和磁共振断层扫描记录治疗前以及治疗后24小时、1个月、3个月和12个月的临床状况和狭窄程度。所有手术在技术上均获成功，未发生术中并发症。在超过一年的观察期内，55%的患者记录显示平均狭窄程度为60%：其中2例（10%）患者血管成形术后出现残余狭窄，9例（45%）出现支架内再狭窄，而只有2例患者记录显示存在血流动力学相关的80%支架内再狭窄。这2例患者接受了球囊扩张治疗。在磁共振断层扫描检查中，没有患者出现神经功能恶化或新的异常。椎动脉闭塞或对侧椎动脉再狭窄均未对临床结局产生负面影响。女性患者发生支架内再狭窄的情况多于男性患者。使用Pharos支架装置进行椎动脉起始部支架置入术是一种有效的狭窄治疗方法。与高再狭窄率相比其良好的临床结果有待进一步研究验证。特别是，必须确定Pharos支架是否能让血管有时间形成侧支循环，双联抗血小板治疗是否能预防复发性脑血管事件，或者仅仅是低再狭窄程度导致了临床结局。
