Journal article
Second Generation Drug-Eluting Stents for Endovascular Treatment of Ostial Vertebral Artery Stenosis: A Single Center Experience
Frontiers in neurology, Vol.10, pp.746-746
07/16/2019
DOI: 10.3389/fneur.2019.00746
PMCID: PMC6646661
PMID: 31379708
Abstract
Objective:
To report a single-center experience using drug-eluting balloon mounted stents (DES) for endovascular treatment of atherosclerotic ostial vertebral artery stenosis (OVAS).
Background:
Posterior circulation is affected in up to 25% of strokes, 20% of them resulting from atherosclerotic OVAS. The optimal management of symptomatic OVAS remains controversial. DES have been introduced to improve restenosis rates.
Methods:
We retrospectively analyzed prospectively collected data from patients with dominant OVAS who underwent endovascular treatment with second-generation DES placement. Patient demographics, clinical presentation, comorbidities, stenosis severity, stent features, technical success, complications, and imaging follow-up were assessed.
Results:
Thirty patients were treated, predominantly male (86.6%). Sixteen patients presented with an acute stroke or TIA and fourteen were treated on an elective basis due to symptomatic chronic stenosis and contralateral occlusion. Comorbidities included hyperlipidemia (83%), hypertension (70%) and prior stroke (63.3%). Mean ostial stenosis at presentation was 80 ± 14.8%. Twenty-one patients had contralateral VA involvement. DES deployment was technically successful in all patients using everolimus eluting stents in 30 lesions and zotarolimus eluting stents in two. One technical complication (stent migration) and three (10%) minor peri-procedural complications occurred. Complications included one asymptomatic ischemic infarct in the posterior circulation, one femoral artery thrombosis and one post-procedure altered mental status secondary to contrast induced neurotoxicity. Mean imaging follow-up was 8.8 months. Two (7.6%) patients had in-stent restenosis and underwent retreatment with angioplasty. There were no procedure-related mortalities.
Conclusion:
Our study confirms the feasibility of deploying DES for the treatment of ostial vertebral artery stenosis with low peri-procedural risk and low medium-term rates of re-stenosis.
Details
- Title: Subtitle
- Second Generation Drug-Eluting Stents for Endovascular Treatment of Ostial Vertebral Artery Stenosis: A Single Center Experience
- Creators
- Santiago Ortega-Gutierrez - Department of Neurology, University of Iowa Hospitals and ClinicsGloria V Lopez - Department of Neurology, University of Iowa Hospitals and ClinicsRandall C Edgell - Department of Neurology, SSM Health Saint Louis University HospitalAldo A Mendez - Department of Neurology, University of Iowa Hospitals and ClinicsSudeepta Dandapat - Department of Neurology, University of Iowa Hospitals and ClinicsJorge A Roa - Department of Neurology, University of Iowa Hospitals and ClinicsCynthia B Zevallos - Department of Neurology, University of Iowa Hospitals and ClinicsAndrea L Holcombe - Department of Neurology, University of Iowa Hospitals and ClinicsDavid Hasan - Department of Neurosurgery, University of Iowa Hospitals and ClinicsColin P Derdeyn - Department of Radiology, University of Iowa Hospitals and ClinicsJames Rossen - Department of Neurology, University of Iowa Hospitals and ClinicsEdgar A Samaniego - Department of Neurology, University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Frontiers in neurology, Vol.10, pp.746-746
- DOI
- 10.3389/fneur.2019.00746
- PMID
- 31379708
- PMCID
- PMC6646661
- NLM abbreviation
- Front Neurol
- ISSN
- 1664-2295
- eISSN
- 1664-2295
- Publisher
- Frontiers Media S.A
- Grant note
- University of Iowa
- Language
- English
- Date published
- 07/16/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Cardiovascular Medicine; Neurosurgery; Otolaryngology; Internal Medicine
- Record Identifier
- 9984070517902771
Metrics
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