Introduction: Endovascular treatment has been considered a good alternative to surgery for symptomatic vertebral artery origin stenosis (VAOS) due to the high morbidity risk associated with surgery.
Methods: The records of 47 patients with VAOS refractory to adequate medication who were treated by endovascular treatment with the Carotid Wallstent from December 2004 to November 2010 were retrospectively evaluated.
Results: Of the 47 patients, 37 presented with transient ischemic attacks or stroke. Thirty-one patients (65.9%) manifested other brachiocephalic stenoses; of these, 26 patients had occlusion, hypoplasia, or stenosis of the contralateral vertebral artery. Overall technical success (defined as 20% or less residual stenosis) was 100%. Procedure-related complications (n = 6, 12.7%) included sudden asystole (n = 1), acute in-stent thrombosis (n = 2), minor stroke (n = 2), and stent shortening (n = 1). All complications were resolved without permanent neurological deficit. Angiographic follow-up (mean, 9.0 months) was achieved in 32 patients and revealed in-stent restenosis in 1 patient (3.1%) and stent malposition by shortening in 2 patients (6.2%). No stent fracture occurred in any of the patients on follow-up angiography. All patients were neurologically stable at clinical follow-up.
Conclusions: Endovascular treatment of symptomatic VAOS using the closed-cell, self-expandable Carotid Wallstent is technically feasible and effective in alleviating patient symptoms and for improving vertebrobasilar blood flow.
Patient Care: It will improve to treat of vertebral artery origin stenosis by using carotid wallstent
Learning Objectives: To evaluate the feasibility and efficacy of insertion of the closed-cell, self-expandable Carotid Wallstent for treatment of VAOS
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