A Reappraisal of Angioplasty and Stenting for the Treatment of Vertebral Origin Stenosis

Abstract

Despite a technical success rate of 97% and a low incidence of complications, VOAS is associated with a high rate of moderate-to-severe restenosis.

Vertebral artery transposition for revascularization of the posterior circulation: a critical assessment of temporary and permanent complications and outcomes

“…Albuquerque et al 1 found restenosis in 43.3% of patients who underwent angioplasty and stenting for revascularization of the proximal VA. Similar results have consistently been reported in other studies.…”

“…Similar results have consistently been reported in other studies. 1,19,20,26 In the Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries trial, 43% of the patients who received treatment for extracranial VA stenosis and had 6 months of follow-up had evidence of in-stent stenosis. Half of them had a complete vessel occlusion.…”

“…Furthermore, the effect of novel agents, including antiplatelet agents and statins, on altering the natural history of these lesions is less well studied. Recent attempts at the use of stenting and/or angioplasty for these lesions has produced mixed results 1,8,26,27 and significant rates of restenosis, ranging from 11% for drug-eluting stents to more than 30% for bare-metal stents.Microsurgical revascularization of the proximal VA has been well described, but the majority of published series included small patient populations and short follow-up ObJect Despite advances in medical management and endovascular therapies, including the introduction of statins, antiplatelet agents, and drug-eluting stents, some patients experience medically refractory vertebrobasilar insufficiency and may benefit from robust surgical revascularization. The aim of this study was to evaluate such patients after surgical revascularization, emphasizing long-term outcomes and rates of complications.…”

“…Furthermore, the effect of novel agents, including antiplatelet agents and statins, on altering the natural history of these lesions is less well studied. Recent attempts at the use of stenting and/or angioplasty for these lesions has produced mixed results 1,8,26,27 and significant rates of restenosis, ranging from 11% for drug-eluting stents to more than 30% for bare-metal stents.…”

Interventional neuroradiology

“…Technical success is high and estimated at 94-98%. Procedure related complications are rare at 0-6% [90][91][92] and include stroke and arterial dissection. The main concern is restenosis at follow up with .…”