Percutaneous interventional treatment of extracranial vertebral artery stenosis with coronary stents

Young Guk Ko, Sungha Park, Jong Youn Kim, Pil Ki Min, Eui Young Choi, Jae Hun Jung, Boyoung Joung, Donghoon Choi, Yangsoo Jang, Won Heum Shim

Research output: Contribution to journalArticle

34 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)629-634
Number of pages6
JournalYonsei medical journal
Volume45
Issue number4
DOIs
Publication statusPublished - 2004 Aug 31

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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