Simultaneous vertebral and subclavian artery stenting.

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurology

Background:

• Vertebrobasilar territory ischemia causes significant neurological deficits.
• Stenosis in both the vertebral artery (VA) and subclavian artery (SA) can cause these symptoms.
• Coexisting ipsilateral VA and proximal SA stenosis represent a complex bifurcation lesion requiring consideration for percutaneous treatment.

Purpose of the Study:

• To assess the safety and efficacy of performing simultaneous angioplasty for both vertebral and subclavian artery stenosis.
• To evaluate the long-term outcomes of this combined percutaneous intervention.

Main Methods:

• Fifteen patients with symptomatic posterior circulation ischemia underwent simultaneous SA/VA angioplasty.
• Procedures involved balloon-mounted stent angioplasty for VA and SA lesions.
• Clinical and duplex ultrasound follow-up was performed at 1, 6, and 12 months post-procedure.

Main Results:

• The technical success rate for the simultaneous angioplasty was 100%.
• Significant reduction in both VA (88.7% to 5.7%) and SA (80% to 11%) stenosis was achieved (p < 0.01).
• No periprocedural stroke, TIA, or death occurred; 66.7% of patients experienced relief from chronic ischemic symptoms during follow-up.

Conclusions:

• Simultaneous stenting of vertebral and subclavian arteries is a safe and effective treatment option.
• The observed restenosis rate is acceptable and treatable with drug-eluting balloons.
• A dual radial and femoral approach can be beneficial in selected cases for procedural facilitation.