Treatment of Vertebral Artery Origin Stenosis with Anti‐Proliferative Drug‐Eluting Stents

Abstract

Vertebral artery origin stenosis is a known cause of stroke that is treatable with angioplasty and stenting. Previous studies have demonstrated that this technique is safe but is limited by high rates of in-stent stenosis. Anti-proliferative drug-eluting stents are an alternative for reducing in-stent stenosis at the vertebral artery origin. This retrospective study included five consecutive patients treated with anti-proliferative drug-eluting stents. The patients' demographics, indications for treatment, procedural technique, and clinical and radiographic follow-up are presented along with a review of the literature. No peri-procedural complications occurred. One patient had a transient ischemic attack (TIA) during the follow-up period. No patients had hemodynamically significant (>50%) in-stent stenosis at follow-up. Among the 287 cases reported in the literature, there were two strokes (.7%), four TIAs (1.4%), and no procedurally related deaths. Among patients undergoing angiographic follow-up, 26% were found to have >50% in-stent stenosis. Anti-proliferative drug-eluting stents hold promise for reducing in-stent stenosis at the vertebral artery origin.