Skip Navigation LinksHome > July 2010 - Volume 67 - Issue 1 > Vertebral Artery Origin Stents Revisited: Improved Results W...
doi: 10.1227/01.NEU.0000370010.09419.23
Clinical Studies

Vertebral Artery Origin Stents Revisited: Improved Results With Paclitaxel‐Eluting Stents

Park, Min S. MD; Fiorella, David MD, PhD; Stiefel, Michael F. MD, PhD; Dashti, Shervin R. MD, PhD; Gonzalez, L. Fernando MD; McDougall, Cameron G. MD; Albuquerque, Felipe C. MD

Collapse Box


BACKGROUND: Vertebral origin angioplasty and stenting (VOAS) with bare metal stents is associated with a high rate of in-stent restenosis (ISR).

OBJECTIVE: We evaluated the rate of ISR after VOAS with drug-eluting stents.

METHODS: Twenty patients (15 men, 5 women; age range, 36–88 years; mean, 63.7 years) were treated for VOAS with a paclitaxel-eluting stent (Taxus Express2, Boston Scientific, Natick, Massachusetts). Stenosis at follow-up was quantified as insignificant (0%–24%), mild (25%–49%), moderate (50%–74%), and severe (75%–100%). ISR was defined using a binary criteria of > 50% stenosis at follow-up angiography.

RESULTS: All procedures were technically successful with no periprocedural complications. Follow-up angiography (range, 4–48 months; mean, 14.7 months) showed insignificant stenosis in 9 patients, mild in 6, moderate in 4, and severe in 1. In 1 patient with “moderate” stenosis, the stent migrated distally; therefore, the lesion restenosis was not within the stent. Thus, 4 of 19 patients (21%) exhibited binary moderate or severe ISR, and 5 of 20 showed restenosis at the lesion (25%). The patient with severe stenosis developed stent thrombosis > 3 years after VOAS.

CONCLUSION: VOAS with drug-eluting stents was associated with a low incidence of periprocedural complications. Although the rate of restenosis was half that seen with the use of bare metallic stents, 21% of patients still developed moderate or severe ISR. These patients may require ≥ 1 revascularization procedures. The risk of delayed stent thrombosis may necessitate lifelong dual antiplatelet medications.

Copyright © by the Congress of Neurological Surgeons


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.