Evaluation of the successful revascularization in extracranial vertebral artery stenosis or occlusion by color Doppler flow imaging

Abstract

Objective To evaluate the value of color doppler flow imaging (CDFI) in successful reconstruction of extracranial vertebral arterial stenosis or occlusion. Methods A total of 27 patients with symptomatic extracranial vertebral artery stenosis or occlusive disease undergoing vertebral artery endarterectomy (VAE) or VAE and stent implantation (VAE+ Stent) were included in this study from Sep. 2015 to Dec. 2017. The difference of vascular diameter and blood flow velocity (PSV and EDV) before and after surgery for the patients with stenosis or occlusive lesions was compared, and the rate of recanalization between VAE and VAE+ Stent was analyzed. Results (1) 11 cases (40.7%) with severe vertebral artery stenosis (VAS) and 16 cases (59.3%) with vertebral artery occlusion (VAO) were detected by CDFI and confirmed by DSA. Among the 27 patients, VAE accounted for 55.6% (15/27 cases), and VAE+ Stent was 44.4% (12/27). The patients with VA stenosis in VAE group accounted for 60% (9/15), while the patients with VA occlusion in VAE+ Stent group accounted for 83.3% (10/12), the difference is statistically significant (χ2=5.185, P=0.023). (2) The rate of recanalization was 96.3% (26/27) in all of 27 patients. The rate of recanalization in patients with VAE+ Stent (91.7%) was higher than that of VAE (73.3%), but there was no statistically difference (χ2=1.485, P=0.223). The rate of recanalization in patients with VAS (72.7%) was lower than VAO (87.5%), but there was no significant difference (χ2=0.943, P=0.332). The patients with VA stenosis in VAE recanalization group accounted for 63.6% (7/11), while the patients with VA occlusion in VAE+ Stent recanalization group accounted for 90.9% (10/11), the difference was statistically significant (χ2=7.071, P=0.008). (3) The diameter and velocity (PSV vs EDV) in patients with VAS and VAO increased after operation (t=13.127, P=0.000, t=6.373, P=0.000 and t=4.866, P=0.001). Conclusion CDFI could be useful for evaluating the success of VAE or VAE+ Stent. Key words: Vertebral artery; Stenosis; Occlusion; Vertebral artery endarterectomy; Recanalization; Ultrasonography, Doppler, color