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Stenting for vertebrobasilar artery stenosis.
T Hatano1, T Tsukahara, E Ogino
1Department of Neurosurgery and Clinical Research Center, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan. taketo@sc4.so-net.ne.jp
Acta Neurochirurgica. Supplement
|August 3, 2005
Summary
Stenting is a safe and feasible treatment for symptomatic vertebrobasilar artery stenosis. While effective, preventing restenosis, particularly in intracranial arteries, remains a key challenge.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Interventional Radiology
Background:
- Vertebrobasilar artery stenosis (VBAS) can cause significant neurological deficits.
- Stenting offers a minimally invasive approach to treat arterial stenosis.
- Limited data exists on long-term outcomes of stenting for VBAS, especially intracranial.
Purpose of the Study:
- To evaluate the feasibility and safety of stenting for symptomatic vertebrobasilar artery stenosis.
- To assess the procedural success and complication rates.
- To analyze the incidence of restenosis and clinical outcomes during follow-up.
Main Methods:
- Retrospective analysis of 116 patients with symptomatic VBAS treated with stenting.
- Inclusion criteria: symptomatic lesion, >60% angiographic stenosis.
- Procedure involved pre-dilatation followed by stent placement under local anesthesia.
Main Results:
- Successful dilatation achieved in 115 patients (99.1%).
- Mean stenosis reduction to 2% (ostial) and 16% (intracranial).
- Restenosis occurred in 9.5% (ostial) and 27% (intracranial) of cases; all treated with PTA. Three patients had recurrent VBI symptoms; one developed brainstem infarction due to in-stent occlusion.
Conclusions:
- Stenting is a feasible and safe endovascular treatment for symptomatic vertebrobasilar artery stenosis.
- Restenosis, particularly in intracranial VBAS, is a significant concern requiring further investigation.
- Ongoing management strategies are needed to prevent restenosis and improve long-term outcomes.