Stenting of vertebrobasilar arteries in symptomatic atherosclerotic disease and acute occlusion: Case series and review of the literature

Abstract

Stenting of the vertebral origin can be performed safely and with a low rate of cerebral ischemic events at follow-up, although restenosis may occur. Larger comparative trials are needed. Treatment decisions in distal vertebrobasilar disease have been made on an individual basis.

Long-term prognosis after revascularization therapy in patients with atherothrombotic stroke

“…In a review of 300 interventions for proximal vertebral artery stenosis, the risk of death was 0.3%, the risk of periprocedural neurological complications was 5.5%, and risk of posterior stroke was 0.7% at a mean follow-up of 14.2 months. Restenosis occurred in 26% of cases after a mean of 12 months (range 3 to 25 months), although restenosis was not consistently correlated with recurrent symptoms (11). When data from 14 case series were combined, the annual stroke risk after angioplasty for distal vertebrobasilar disease was approximately 3%, and rates of stroke and restenosis appeared to be related to ascending (more distal) location and the anatomic complexity of the offending lesion.…”

Stenting for Severe Vertebral Artery Orifice Stenosis in A Case of Three Cerebral Artery Occlusion

“…VA angioplasty was first performed in 1980 by Sundt et al Numerous clinical studies conducted since then have indicated the importance of angioplasty and stenting in the treatment of vertebrobasilar atherosclerotic disease (13)(14)(15)(16)(17). Technical success depends on the development of materials used in endovascular treatment, the degree of stenosis, the vascular tortuosity, and the experience of the neuroradiologist who performs the procedure.…”

Endovascular Angioplasty for Extracranial Vertebral Artery Occlusion Without Visualization of the Stump of the Artery Ostium

“…3,9,14,21) However, a systematic review of percutaneous revascularization of extracranial VA stenosis found no differences in periprocedural stroke rates with or without protection devices. 16) Similarly, the endovascular treatment without an embolic protection device performed in our case did not result in procedural thromboembolic complication.…”