Results of proximal vertebral arteries endovascular interventions

Chechetkin A.O., Suslina Z.A., Skrylev S.I., Kuntshevich G.I., Koshcheev A.Yu., Protsky S.V., Shchipakin V.L., Lagoda O.V., Krasnikov A.V.

Objective: to evaluate immediate and long-term clinical and ultrasound efficacy of proximal vertebral arteries stenting.

We studied 74 subjects (age 61±10 years) who underwent transluminal balloon angioplasty with stenting of vertebral arteries (77 vessels). Technical success (i.e., residual stenosis <20%) was achieved in 95% patients. No events (acute stroke, myocardial infarction, or death) were recorded during the procedure or in early postoperative period. Clinical improvement was seen in 81% patients presented with symptoms of vetebrobasilar insufficiency at the baseline (n=52). Sixty six patients (89%) were followed up in the late postoperative period (6 to 54 months after the intervention). No events of acute stroke were recorded in the vertebrobasilar circulation. Relapse of vertebrobasilar symptoms after temporary improvement was seen in 13% patients. Stent restenosis/occlusion was diagnosed in 36% patients although no relationship was revealed between the alteration of stent patency and relapse of clinical symptoms. Restenosis correlated with initial stenosis of ≥70% (р<0.05) and type of stent material. Use of cobalt chromium stents was associated with 2-fold decrease of restenosis rate vs non cobalt chromium stents (24% vs 50%, respectively, р<0.05).

Therefore, stenting of proximal vertebral arteries yields good technical and clinical results. High restenosis rate is a major problem of endovascular treatment of atherosclerosis and needs further evaluation.

KEY WORDS: endovascular treatment, stenting, vertebrobasilar insufficiency, ostial vertebral artery stenosis, restenosis.

P.55-61

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