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Long-term outcome of elective stenting for symptomatic intracranial vertebrobasilar stenosis
1Neurovascular Angioplasty Team, Department of Neurology, Beijing Tiantan Hospital, The Capital University of Medical Sciences, Beijing, China. cjr.jiangweijian@vip.163.com
Insights
Endovascular stenting effectively treated symptomatic vertebrobasilar artery (VBA) stenosis, showing a low annual stroke rate of 4.6%. Most patients achieved independence, suggesting favorable outcomes compared to medical management.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Cardiology
Background:
- Atherosclerotic stenosis of the vertebrobasilar artery (VBA) is a significant cause of ischemic stroke.
- Intracranial stenosis poses a high risk for patients, with limited treatment options.
- Medical therapy alone may not be sufficient for severe VBA stenosis.
Purpose of the Study:
- To evaluate the safety and efficacy of elective stenting for symptomatic intracranial vertebrobasilar artery (VBA) stenosis.
- To determine the stroke and death rates in patients undergoing VBA stenting.
- To assess long-term functional outcomes after VBA stenting.
Main Methods:
- Seventy-nine consecutive patients with > or = 50% symptomatic atherosclerotic VBA stenosis underwent elective stenting.
- Clinical outcomes, including stroke and death, were monitored within 30 days and long-term.
- Functional independence was assessed using the modified Rankin scale.
Main Results:
- Five strokes occurred within 30 days post-procedure.
- Three additional strokes occurred in the VBA territory after 30 days (mean follow-up 812 days).
- The annual stroke rate in the VBA territory was 4.6%, including early stroke and death.
- 73 out of 79 patients were independent (modified Rankin scale grade <= 2) at last follow-up.
Conclusions:
- Elective stenting for symptomatic intracranial VBA stenosis is associated with acceptable early and late stroke rates.
- VBA stenting demonstrated favorable functional outcomes, with a high rate of patient independence.
- The results suggest that stenting is a viable and effective treatment option compared to medical therapy for this patient group.
Abstract:
Seventy-nine consecutive patients with symptomatic atherosclerotic stenosis > or = 50% of intracranial vertebrobasilar artery (VBA) were treated by elective stenting. There were five strokes within 30 days, and three strokes in the VBA territory after 30 days (mean of 812 days). The annual stroke rate in the VBA territory (including any stroke and death within 30 days) was 4.6%. At the last follow-up time, 73 patients were independent (modified Rankin scale grade < or = 2). The outcome compares favorably with medical therapy.