Multicenter Study of Safety in Stenting for Symptomatic Vertebral Artery Origin Stenosis: Results from the Society of Vascular and Interventional Neurology Research Consortium

摘要

PURPOSE: To assess the safety and efficacy of vertebral artery origin angioplasty and stenting for stroke prevention in a multicenter clinical experience. METHODS: Patients with symptomatic vertebral artery origin stenosis (VAOS) were gathered from the Society of Vascular and Interventional Neurology Research Consortium. Demographic, clinical, and procedural data were collected. The main outcome measure was procedural and peri-procedural risks of stroke, transient ischemic attack (TIA), or death at 1 and 3 months. Logistic regression analysis was used to assess covariates associated with future restenosis. RESULTS: A total of 148 patients were included with mean age of 66.2±11.5; 74% men and 77% Caucasian. One patient (8%) had a stroke at 1 month and 5 of 96 (5.2%) patients had TIA at 3 months. There were no immediate procedural events or deaths. The mean angiographic pre-treatment stenosis was 80.5 ± 12.7%, which was reduced to 5.3 ± 9.1% after stent deployment. Follow-up angiography showed 15.5% of patients had significant restenosis (≥50%). Predictors of restenosis included age (OR 3.08; 95% CI 1.01, 9.41) and smoking (OR 3.10; 95% CI 1.12, 8.64). CONCLUSIONS: Endovascular intervention of VAOS is associated with low peri-procedural complication rates. Restenosis remains a concern; age and smoking predicted future restenosis.