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.

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IntroductionVertebral artery stenosis is a major cause of posterior circulation ischemia in the elderly. There is not a clear consensus on the optimal therapeutic approach for symptomatic extracranial vertebral artery stenosis.AimTo evaluate the feasibility and efficacy of balloon-expandable stent angioplasty in the treatment of vertebral artery stenosis in the V2 segment.Material and methodsFive patients with vertebral artery stenosis (V2 segment) and treatment of percutaneous transluminal stenting from July 2009 to June 2014 were retrospectively evaluated. All patients underwent color Doppler, transcranial color Doppler (TCD), CT angiography (CTA) and cerebral digital subtraction angiography (DSA) preoperatively. Whether there was osseous oppression was determined according to neck computed tomography (CT) and CTA. After the surgery, angiography was performed to determine if there was infarction or bleeding in the intracranial vertebral artery, basilar artery and posterior cerebral artery. The surgical parameters, residual stenosis, complications, etc. were recorded and evaluated. The patients were followed up accordingly.ResultsFive patients (3 males, 2 females; average age of 66 ±4.2, range of 54–75) were enrolled in the study. Balloon-expandable stents were successfully implanted in the 5 patients. The mean residual stenosis after the balloon-expandable stenting (preoperative: average, 87.0 ±6.6%, range: 75–93%) was 12.6 ±7.8% (range: 5–25%). The clinical symptoms disappeared or receded. No serious complications occurred.ConclusionsThe balloon-expandable stent angioplasty seemed to be feasible and efficacious in treating vertebral artery stenosis in the V2 segment. Further study with a large sample size is needed.

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