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Endovascular revascularization of chronically occluded vertebral artery: single-center experience
Xueli Cai1,2, Liangtong Huang2, Xueping Chen2
1Department of Neurology, The Second Afliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
Insights
Endovascular therapy, including balloon dilatation and stenting, is a feasible and safe treatment for chronic vertebral basilar artery occlusion. This approach successfully restored blood flow and prevented recurrent ischemic events in patients.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Cardiology
Background:
- Chronic vertebral basilar artery occlusion is a significant cause of ischemic stroke, accounting for approximately 20% of cases.
- Limited evidence exists regarding the effectiveness of treatments for the initial segment of this condition.
Purpose of the Study:
- To assess the feasibility and efficacy of endovascular therapy for chronic vertebral basilar artery occlusion in its initial segment.
Main Methods:
- A retrospective study was conducted using data from Lishui Hospital of Zhejiang University.
- Patients treated for initial segment vertebral basilar artery occlusion between September 2014 and September 2018 were identified.
Main Results:
- Successful recanalization was achieved in 86.36% of the 22 patients.
- Treatments included balloon dilatation (5 cases) and balloon dilation with stent implantation (14 cases).
- No recurrent ischemic events were observed during follow-up, though 27.27% showed angiographic re-stenosis.
Conclusions:
- Endovascular treatment, utilizing balloon dilatation or combined with stenting, is a feasible and safe option for managing chronic vertebral basilar artery occlusion in the initial segment.
Introduction:
Chronic vertebral basilar artery occlusion is one of the most common causes of ischemic stroke, which accounts for roughly 20% of all cases. However, the evidence for the precise clinical effect in treatment of the initial segment of chronic vertebral basilar artery occlusion is not sufficient.
Aim:
To evaluate the feasibility and efficacy of endovascular therapy in the initial segment of chronic vertebral basilar artery occlusion.
Material And Methods:
This is a retrospective study based on data obtained from Lishui Hospital of Zhejiang University. We identified patients who underwent treatment for initial segment occlusion of the vertebral basilar artery from September 2014 to September 2018.
Results:
Among a total of twenty-two subjects, 77.27% of them were men and the median age was 61 years old. The primary medical history of these patients included hypertension (15, 68.18%), hyperlipidemia (13, 59.09%), diabetes mellitus (11, 50.00%), and coronary artery disease (6, 27.27%). About 54.54% of the patients were current smokers. Successful recanalization was achieved in 86.36% of patients. Five cases of balloon dilatation were recanalized and fourteen cases were treated by balloon dilation combined with stent implantation. During the follow-up period, there were no recurrent cerebral ischemic events, including transient ischemic attack or stroke. Six (27.27%) arteries were found to exhibit angiographic re-stenosis.
Conclusions:
The clinical effect of balloon dilatation or balloon dilatation combined with stenting in the treatment of chronic vertebral basilar artery occlusion in the beginning segment was feasible and safe.
