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Endovascular treatment of extracranial vertebral artery stenosis

Burak Kocak1, Bora Korkmazer, Civan Islak

  • 1Burak Kocak, Bora Korkmazer, Civan Islak, Naci Kocer, Osman Kizilkilic, Department of Radiology, Division of Neuroradiology, Cerrahpasa School of Medicine, Istanbul University, 34098 Istanbul, Turkey.

World Journal of Radiology
|October 2, 2012
PubMed

Insights

Percutaneous angioplasty and stenting for vertebral artery stenosis is a feasible treatment. However, more randomized trials are needed to prove its superiority over medical management.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Neurology

Background:

  • Extracranial vertebral artery (VA) stenosis can cause posterior circulation symptoms.
  • Percutaneous angioplasty and stenting (PAS) is a potential treatment option.

Purpose of the Study:

  • To evaluate the safety, efficacy, and long-term outcomes of PAS for extracranial VA stenosis.
  • To identify challenges and potential solutions, such as stent selection and restenosis management.

Main Methods:

  • Comprehensive literature review of studies on PAS for extracranial VA stenosis.
  • Analysis of technical feasibility, complication rates, and long-term results.
  • Consideration of challenging cases, including severe vessel tortuosity and restenosis.

Main Results:

  • PAS appears safe and effective for improving symptoms and posterior circulation blood flow.
  • Stent placement can be challenging in tortuous vessels; coronary balloon-expandable stents may be preferred.
  • Restenosis rates show significant variability, suggesting drug-eluting stents as a potential solution.

Conclusions:

  • PAS is technically feasible for extracranial VA stenosis.
  • Current evidence from randomized trials is insufficient to establish endovascular management superiority over best medical management.

Keywords:
AngioplastyEndovascular treatmentStentVertebral artery stenosis

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