Endovascular treatment of the vertebral artery origin in patients with symptoms of vertebrobasilar ischemia

Guilherme Dabus, Ronald J. Gerstle, Colin P. Derdeyn, De Witte T. Cross, Christopher J. Moran

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46 Scopus citations

Abstract

Introduction: We report our experience with the endovascular treatment of the vertebral artery origin in patients presenting with symptomatic vertebrobasilar ischemia and compare our results with those reported in the literature. Methods: In 25 patients, 28 procedures were performed. Patients presented with posterior circulation ischemic symptoms despite optimal medical therapy with antiplatelet drugs and had a digital subtraction angiogram demonstrating stenosis of the origin of the vertebral artery greater than 50%. Retrospective review of the medical records, clinical notes and radiologic-procedural reports was performed. Results: Of the 25 patients, 18 were male and 7 female. Their ages ranged from 50 to 84 years. In 23 of the 25 patients the contralateral vertebral artery was occluded, hypoplastic, absent, or had greater than 50% stenosis. In 13 of the 25 patients angiographic evidence of significant anterior circulation disease was demonstrated. In 18 of the 25 patients the left vertebral artery was affected. The mean stenosis was 82.6%. Follow-up records were available in 19 patients. The mean follow-up was 24 months. Five of the 19 patients had recurrent symptoms of vertebrobasilar ischemia and three patients were retreated. Of the 28 procedures performed, 23 were angioplasty/stenting and 5 were angioplasties alone. Overall technical success was achieved in 26 of the 28 procedures (92.8%). No procedure-related transient ischemic attack, stroke or death was noted. Conclusion: Endovascular treatment of the vertebral artery origin in this patient population is feasible, safe, and effective. There are some questions regarding the long-term follow-up and rate of restenosis and clinical recurrences that are yet to be answered.

Original languageEnglish
Pages (from-to)917-923
Number of pages7
JournalNeuroradiology
Volume48
Issue number12
DOIs
StatePublished - Dec 2006

Keywords

  • Angioplasty
  • Endovascular
  • Posterior circulation
  • Stenting
  • Stroke
  • Vertebral artery

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