Treatment of stenoses of vertebral artery origin using short drug-eluting coronary stents: improved follow-up results
| Autor: | Elina Miloslavski, Zsolt Vajda, A. Heuschmid, Sebastian Fischer, Thomas Güthe, G. Albes, Hans Henkes |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Paclitaxel Vertebral artery medicine.medical_treatment Restenosis Blood vessel prosthesis medicine.artery Coronary stent medicine Vertebrobasilar Insufficiency Humans Radiology Nuclear Medicine and imaging Aged Aged 80 and over medicine.diagnostic_test Interventional business.industry Stent Drug-Eluting Stents Middle Aged medicine.disease Clopidogrel Coronary Vessels Tubulin Modulators Surgery Blood Vessel Prosthesis Radiography Stenosis Treatment Outcome Angiography Female Neurology (clinical) Radiology business medicine.drug |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X |
| Popis: | BACKGROUND AND PURPOSE: Recent studies on stent placement of significant stenoses at the origin of the vertebral artery reported excellent immediate results. Long-term outcomes, however, were disappointing due to high restenosis rates and stent breakage. In the present study, we evaluated the application of a short drug-eluting balloon-expandable coronary stent for the endovascular treatment of these frequent lesions. MATERIALS AND METHODS: In a period of 23 months, 48 patients (12 women, 36 men) with a mean age of 68 years (range, 46–82 years) harboring 52 significant ostial vertebral artery stenoses underwent treatment with short (8 mm) balloon-expandable paclitaxel-eluting coronary stents. Stents were deployed as closely as possible so that the proximal end was just at the origin of the vertebral artery, with high inflation pressure applied. Patients were under continuous medication with acetylsalicylic acid and clopidogrel before and after the treatment. Follow-up clinical assessment and angiography were performed in all patients. RESULTS: Periprocedural complications were not encountered. Stenosis severity was reduced from 62 ± 2% (mean ± standard error of the mean) preprocedurally to 15 ± 2% postprocedurally. Follow-up angiography at 7.7 ± 0.6 months revealed a mean stenosis degree of 24 ± 3%. None of the patients developed posterior circulation symptoms related to the treated segment during the follow-up period. Recurrent stenosis (>50%) at follow-up was found in 6 (12%) lesions. CONCLUSIONS: Stent placement of significant ostial vertebral artery stenosis by using short drug-eluting stents is safe and yields good midterm patency rates and excellent protection from posterior circulation ischemia. |
| Databáze: | OpenAIRE |
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