Clinical Study On Endovascular Angioplasty And Stenting Placement For The Treatment Of Vertebral Artery Origin Stenosis

Purpose: The vertebral artery origin stenosis is a major reason of the posteriorcirculation ischemic stroke. Endovascular angioplasty and stenting placement may bea safe and effective treatment for the patient with symptomatic vertebral arterystenosis under optimum medicine management. The purpose of this research is toevaluate the efficiency and the complications of this technic.Methods: This is a retrospective, single center clinical trial. Patients werecontinually enrolled in Common Interventional Radiology Department of TiantanHospital. Digital subtraction angiography(DSA) was performed in all cases beforestenting placement to confirm symptomatic related stenosis. We finally placedballoon-expandable stents (BES) for all patients. Change of clinical symptomscompared with pre-operation，the rate of technical success and complications ofperioperative period were viewed and recorded. Risk factors was analyzed by logisticregression analysis.Results: A total of119patients with vertebral artery origin stenosis were recruitedinto the study from November2011to August2012，there were98males and21females, with a mean age of63.7±10.0years (range32-80) and a mean stenosis rateof84.5±5.6%.In a total of124BES placements,119were in vertebral artery originand5were in distal. All the BES placements were technically successful, meanresidual stenosis was1.3±3.1%. There were no surgery related complications andnerve function or symptoms deteriorate.115patients had symptoms disappeared orsignificant improved with a mean follow-up period of8.2±3.8months, only onepatient had missing. Imageology follow up of115patients, the in-stent restenosis ratewas24.4%,2patients had stent fractured. Logistic regression analysis shows thatresidual stenosis and hyperlipidemia might contribute to the risk of in-stent restenosis. Conclusion:1. Endovascular angioplasty and stenting placement is a highsuccessful rate treatment in technical for vertebral artery origin stenosis with a lowincidence of complications and a significant improvement in symptoms.2.The rate ofin-stent restenosis is still high.3. Long-term efficacy and the evidence-based medicineare waiting for more observation from random clinical trials.