Summary
We report our experience with stenting for symptomatic vertebrobasilar artery stenosis. One hundred and sixteen patients with vertebro-basilar artery stenosis (101 vertebral ostial stenosis, 15 intracranial vertebrobasilar artery stenosis) were treated with stenting. Indication criteria of treatment were 1) symptomatic lesion, 2) angiographical stenosis more than 60%. Under local anesthesia, pre-dilatation was first performed, then stents were placed to the lesion. Successful dilatation was obtained in 115 cases. The stenosis rate reduced to 2% post-stenting in ostial lesions and 16% in intracranial lesions. Transient neurological complications developed in 2 patients. Follow-up angiographies more than 6 months after stenting were performed in 94 patients with ostial lesions and all patients with intracranial lesions. Of these, 8 patients (9.5%) with ostial lesions and 4 patients (27%) with intracranial lesions developed restenosis. All patients with restenosis were treated successfully with PTA (percutaneous transluminal angioplasty). During the follow-up period, 3 patients developed recurrence of VBI (vertebro-basilar insuffciency) symptoms due to restenosis. One patient developed brain stem infarction due to in-stent occlusion 8 months after stenting.
Conclusion. Stenting for vertebrobasilar artery stenoses is feasible and safe. Prevention of restenosis, especially in intracranial arteries, is the next problem to be solved.
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Hatano, T., Tsukahara, T., Ogino, E., Aoyama, T., Nakakuki, T., Murakami, M. (2005). Stenting for vertebrobasilar artery stenosis. In: Yonekawa, Y., Keller, E., Sakurai, Y., Tsukahara, T. (eds) New Trends of Surgery for Stroke and its Perioperative Management. Acta Neurochirurgica Supplements, vol 94. Springer, Vienna. https://doi.org/10.1007/3-211-27911-3_22
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DOI: https://doi.org/10.1007/3-211-27911-3_22
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