[Endoluminal dilatations and stenosis of symptomatic vertebral arteries]

Surgical treatment of symptomatic atherosclerotic stenosis of vertebral arteries has been proposed for many years but this technique remains quite confidential due to technical difficulties and relatively high risks. Transluminal angioplasty has been proposed and we developed a simplified technique using coronary stent placement. The aim of this study was to evaluate the feasibility and efficacy of transluminal angiography with primary stenting for proximal stenosis for vertebral arteries. Eleven patients with symptomatic atherosclerotic stenosis of vertebral arteries were treated by trans luminal angioplasty with primary stent placement. Two patients, one with stenosis of the proximal vertebral artery and one with distal stenosis of the vertebral artery where only treated by transluminal angioplasty. In all cases transluminal angioplasty and stenting were feasible with restitution ad integrum of the diameter of the artery in 98 cases and with residual moderate stenose (<20%) in 5 cases. All patients were followed for more than one year, only one patient had recurrence of symptoms, but he stopped spontaneously the anti platteless drugs. Vertebro basilar symptoms disappeared completely in 12/13 cases and were improved in 1/13 cases. No restenose of the artery was observed on control (echodoppler) excepted in one case, where a tight stenose of pre vertebral sub clavian artery developed. Transluminal angioplasty for symptomatic stenosis of vertebral artery appears as a very successful technique with a low complication rate. It should be proposed in many cases of vertebrobasilar insufficiency related with tight vertebral artery stenosis.