Efficacy analysis of vertebral artery origin and adjacent subclavian artery stenosis treated with a single self-expandable stent implantation / 中国脑血管病杂志

ABSTRACT

Objective Toinvestigatethetechnicalfeasibilityandefficacyofvertebralarteryorigin and adjacent subclavian artery stenosis treated with a single self-expandable stent implantation simultaneously. Methods Twenty-onepatientswithposteriorcirculationischemicsymptomsweretreatedwithasingle stent implantation for vertebral artery origin (stenosis rate≥70%)and adjacent subclavian artery stenosis (stenosis rate ≥50%)simultaneously. The head end of a single self-expandable open-cell stent was implanted into the middle or distal V1 segment of vertebral artery,and the caudal end was implanted at the proximal subclavian artery during procedure. At 6 -12 months after procedure they received followed-up with CTA and/or DSA. The clinical and image data of the patients were analyzed retrospectively. Results Allstentswereimplantedsuccessfully.Thevertebralarterystenosisratewasdecreasedfrom 87. 1 ± 5. 7% before procedure to 7. 4 ± 6. 4% and the subclavian artery stenosis rate was decreased from 61.9±8.4% to4.5±5.7% aftertheprocedure.Therewassignificantdifference(allP<0.05).No perioperative complications occurred. The in-stent restenosis (about 50%) was found in one patient (4.8%)during the follow-up and he did not have any relevant clinical symptoms. One patient (4. 8%) had recurrent vertigo at 6 months after procedure. CTA and DSA examinations revealed stent compression and vertebralarteryocclusion.Conclusion Asingleself-expandablestentimplantationforthetreatmentof vertebral artery origin and adjacent subclavian artery stenosis simultaneously is feasible and safe. The incidences of in-stent stenosis and stent compression are low.