Endovascular treatment of vertebral artery ostial stenosis with second generation drug-eluting coronary stents: Long-term follow up

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-18 DOI:10.1016/j.jstrokecerebrovasdis.2025.108429

Fatih ÖNCÜ MD , Nezih YAYLI MD , Taylan ALTIPARMAK MD , Abdullah ÖZER MD , Hale Zeynep BATUR ÇAĞLAYAN MD , Mehmet Koray AKKAN MD , Ahmet Baran ÖNAL MD , Bijen NAZLIEL MD , Erhan Turgut ILGIT MD

{"title":"Endovascular treatment of vertebral artery ostial stenosis with second generation drug-eluting coronary stents: Long-term follow up","authors":"Fatih ÖNCÜ MD , Nezih YAYLI MD , Taylan ALTIPARMAK MD , Abdullah ÖZER MD , Hale Zeynep BATUR ÇAĞLAYAN MD , Mehmet Koray AKKAN MD , Ahmet Baran ÖNAL MD , Bijen NAZLIEL MD , Erhan Turgut ILGIT MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108429","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Purpose</h3><div>To evaluate the patency and clinical outcomes of drug-eluting stents (DES) in patients with symptomatic and significant vertebral artery ostial stenosis (VAOS).</div></div><div><h3>Methods</h3><div>This single-center, retrospective observational study included 31 patients (21 males, 10 females; mean age: 64 ± 10.56 years) who underwent DES placement for severe (>70 %) symptomatic VAOS in our institution between 2013 and 2023. Patients who had received DES placement for other indications—such as dissection, aneurysm, or intracranial vertebral artery stenosis—were excluded. The primary outcomes were technical success, clinical response, and the incidence of peri‑procedural and post-procedural complications. Data were collected and assessed using the hospital's electronic medical records. Follow-up imaging was primarily performed using Doppler ultrasonography (DUS). In equivocal cases, digital subtraction angiography (DSA) and computed tomography angiography (CTA) were performed. Descriptive statistics were used to summarize the data. Continuous variables are presented as mean ± standard deviation, while categorical variables are expressed as counts and percentages.</div></div><div><h3>Results</h3><div>Technical success was achieved in all patients (100 %). The mean follow-up duration was 20 ± 4 months. Two patients were lost to follow-up and excluded from follow-up analysis. Although no significant restenosis was detected during follow-up, mild in-stent restenosis (<30 %) was observed in two symptomatic patients (6.9 %), both of whom were successfully treated with medical therapy. Our findings demonstrate favorable short-term neurological improvement in acute stroke cases, along with sustained symptom control during long-term follow-up (93.1 %).</div></div><div><h3>Conclusion</h3><div>This study supports the long-term efficacy and safety of second-generation DES in treating VAOS. The results are consistent with the Vertebral Artery Ischaemia Stenting Trial (VIST), particularly in demonstrating low complication rates in extracranial vertebral artery stenosis.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108429"},"PeriodicalIF":1.8000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stroke & Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1052305725002071","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Purpose

To evaluate the patency and clinical outcomes of drug-eluting stents (DES) in patients with symptomatic and significant vertebral artery ostial stenosis (VAOS).

Methods

This single-center, retrospective observational study included 31 patients (21 males, 10 females; mean age: 64 ± 10.56 years) who underwent DES placement for severe (>70 %) symptomatic VAOS in our institution between 2013 and 2023. Patients who had received DES placement for other indications—such as dissection, aneurysm, or intracranial vertebral artery stenosis—were excluded. The primary outcomes were technical success, clinical response, and the incidence of peri‑procedural and post-procedural complications. Data were collected and assessed using the hospital's electronic medical records. Follow-up imaging was primarily performed using Doppler ultrasonography (DUS). In equivocal cases, digital subtraction angiography (DSA) and computed tomography angiography (CTA) were performed. Descriptive statistics were used to summarize the data. Continuous variables are presented as mean ± standard deviation, while categorical variables are expressed as counts and percentages.

Results

Technical success was achieved in all patients (100 %). The mean follow-up duration was 20 ± 4 months. Two patients were lost to follow-up and excluded from follow-up analysis. Although no significant restenosis was detected during follow-up, mild in-stent restenosis (<30 %) was observed in two symptomatic patients (6.9 %), both of whom were successfully treated with medical therapy. Our findings demonstrate favorable short-term neurological improvement in acute stroke cases, along with sustained symptom control during long-term follow-up (93.1 %).

Conclusion

This study supports the long-term efficacy and safety of second-generation DES in treating VAOS. The results are consistent with the Vertebral Artery Ischaemia Stenting Trial (VIST), particularly in demonstrating low complication rates in extracranial vertebral artery stenosis.

查看原文本刊更多论文

第二代药物洗脱冠状动脉支架治疗椎动脉口狭窄：长期随访

背景与目的探讨药物洗脱支架（DES）治疗有明显症状的椎动脉口狭窄（VAOS）的通畅性和临床效果。方法本研究为单中心、回顾性观察性研究，纳入我院2013年至2023年间因严重（> 70%）症状性VAOS接受DES安置的31例患者（男性21例，女性10例，平均年龄64±10.56岁）。排除了因其他适应症（如夹层、动脉瘤或颅内椎动脉狭窄）而接受DES放置的患者。主要结果是技术成功、临床反应、术中和术后并发症的发生率。使用医院的电子医疗记录收集和评估数据。随访主要采用多普勒超声（DUS）。在模棱两可的情况下，进行数字减影血管造影（DSA）和计算机断层血管造影（CTA）。采用描述性统计对数据进行汇总。连续变量以均数±标准差表示，分类变量以计数和百分比表示。结果所有患者均获得技术成功（100%）。平均随访时间20±4个月。2例患者失访，排除随访分析。虽然随访期间未发现明显的再狭窄，但2例有症状患者（6.9%）出现轻度支架内再狭窄（30%），均经药物治疗成功。我们的研究结果表明，急性脑卒中患者在短期内有良好的神经系统改善，在长期随访中症状得到持续控制（93.1%）。结论本研究支持第二代DES治疗VAOS的长期疗效和安全性。结果与椎动脉缺血支架置入试验（VIST）一致，特别是显示颅外椎动脉狭窄并发症发生率低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.