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Percutaneous Interventional Treatment of Extracranial Vertebral Artery Stenosis with Coronary Stents

 Young Guk Ko  ;  Sungha Park  ;  Won Heum Shim  ;  Yangsoo Jang  ;  Donghoon Choi  ;  Boyoung Joung  ;  Jae Hun Jung  ;  Eui Young Choi  ;  Pil Ki Min  ;  Jong Youn Kim 
 YONSEI MEDICAL JOURNAL, Vol.45(4) : 629-634, 2004 
Journal Title
Issue Date
Adult ; Aged ; Angiography ; Angioplasty, Balloon* ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents* ; Treatment Outcome ; Vertebrobasilar Insufficiency/diagnosis ; Vertebrobasilar Insufficiency/therapy*
vertebral artery ; vertebrobasilar artery insuffici-ency ; oercytaneous transluminal angioplasy ; stenting
Stenosis of extracranial vertebral artery (VA) is not an infrequent lesion, and it can pose a significant clinical problem. However, the standard treatment for a significant VA stenosis has still not been established. Here in this study, we report our experiences of VA stenting in 25 patients (age 56.2 ± 15.2 years, male 76%). The patients had comorbidities as follows: DM (36%), hypertension (64%), Takayasu's (12%) and Behcet's diseases (4%). There were combined involvement of other vessels such as the coronary artery (72%), carotid artery (36%), subclavian artery (32%) and the contralateral vertebral artery (24%). Indications for stenting were prior stroke or symptoms related to vertebrobasilar ischemia in 11 patients, and an asymptomatic but angiographically significant stenosis (> 70% stenosis) in 14 patients. Twenty-three balloon-expandable stents and two self-expandable stents were deployed. A drug-eluting coronary stent and distal balloon protection device were each used in one case. A technically successful procedure was achieved in all patients. The baseline reference diameter was 4.7 ± 1.3 mm, minimal luminal diameter (MLD) 1.0 ± 0.6 mm (diameter stenosis 77.8 ± 12.5%) and lesion length 6.4 ± 3.9 mm. After stenting and adjuvant dilation, the MLD was increased to 4.5 ± 0.9 mm (diameter stenosis 3.1 ± 17.9%). There were no procedure-related complications. During the further follow-up period of 25 (3-49) months, no stroke or death occurred. Restenosis was observed in 4 (30.8%) of 13 eligible patients. In conclusion, VA stenting is feasible with a high degree of technical success, and this treatment is associated with a relatively low incidence of procedure-related complications. However, a relative high rate of in-stent restenosis remains as a problem to be resolved.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Shim, Won Heum(심원흠)
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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