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The long term results of vertebral artery ostium stenting in a single center
1Department of Interventional Neuroradiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
Insights
Vertebral artery ostium stenting is safe and effective, with most long-term recurrent events being transient ischemic attacks. Risk factors for these TIAs include in-stent restenosis, stent fracture, vessel tortuosity, and hyperlipidemia.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Cardiovascular Research
Background:
- Long-term outcomes of vertebral artery ostium (VAO) stenting are not well-established.
- Atherosclerotic VAO stenosis is a significant cause of ischemic events.
Purpose of the Study:
- To evaluate the incidence of recurrent ischemic events after VAO stenting.
- To identify risk factors associated with these long-term recurrent events.
Main Methods:
- Retrospective analysis of 202 VAO stenting procedures in 190 patients.
- Follow-up data analyzed for recurrent transient ischemic attack (TIA), stroke, vascular mortality, in-stent restenosis (ISR), and stent fracture.
- Risk factor analysis including patient demographics and VAO morphology.
Main Results:
- 18.1% of patients experienced recurrent TIAs; no strokes or deaths occurred.
- In-stent restenosis (ISR) was observed in 21.2% and stent fracture in 4.7% of patients.
- Recurrent events were associated with ISR, stent fracture, vessel tortuosity, and hyperlipidemia.
Conclusions:
- Vertebral artery ostium stenting demonstrates safety and efficacy for symptomatic stenosis.
- Recurrent TIAs are the predominant long-term event, potentially linked to ISR, stent fracture, vessel tortuosity, and hyperlipidemia.
Background And Purpose:
The long term results of vertebral artery ostium (VAO) stenting remain uncertain. We sought to evaluate the incidence and risk factors for recurrent ischemic events on long term follow-up in patients who have undergone VAO stenting.
Methods:
190 consecutive patients who had undergone a total of 202 stenting procedures for symptomatic atherosclerotic VAO stenosis between January 2011 and December 2012 were screened. Baseline demographics of the patients and morphological features of VAO were recorded. The primary outcome events analyzed included recurrent transient ischemic attack (TIA), stroke, and vascular related mortality. Risk factors for these recurrent events were identified. Other outcome events analyzed included in-stent restenosis (ISR) ≥50% and stent fracture noted on follow-up.
Results:
Of the 188 patients with available follow-up data (mean follow-up period 16.7 months), 34 patients suffered recurrent TIAs (18.1%); none had stroke or death. 40 patients were found to have ISR (21.2%) and nine patients had stent fracture (4.7%). Patients with recurrent events were significantly more likely to have ISR, stent fracture, vessel tortuosity, and hyperlipidemia than patients without recurrent events.
Conclusions:
Stenting for VAO stenosis seems to be safe and efficacious. The majority of recurrent events were TIAs, which may be related to ISR, stent fracture, vessel tortuosity, and hyperlipidemia.
