Symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting

Eur J Radiol. 2015 Sep;84(9):1801-4. doi: 10.1016/j.ejrad.2015.05.033. Epub 2015 Jun 5.

Abstract

Purpose: To investigate the safety, effect and instent restenosis rate of Wingspan stenting in treating patients with intracranial vertebral artery atherosclerotic stenosis (70-99%) concurrent with contralateral vertebral artery atherosclerotic diseases.

Materials and methods: Eighty-eight patients with severe symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) combined with contralateral vertebral artery atherosclerotic diseases were treated with the Wingpsan stent. All the baseline, cerebral angiography, success rate, perioperative complications, clinical and imaging follow-up data were prospectively analyzed.

Results: The success rate of stenting was 100%, and the mean stenotic rate was reduced from prestenting (84.9±6.8)% to poststenting (17.2±5.9)%. The perioperative stroke rate was 1.1%. Among eighty patients (90.9%) with clinical follow-up 8-62 months (mean 29.3±17.2) poststenting, five (6.3%) had posterior circulation TIA only, three (3.8%) had mild stroke in the posterior circulation but recovered completely, and another five patients greater than 70 years old died of non-ischemic stroke. Imaging follow-up in 46 patients (52.3%) 5-54 months (mean 9.9±9.9) following stenting revealed instent restenosis in 12 patients (26.1%) including 7 (58.3%) symptomatic restenosis. Age and residual stenosis were the two factors to significantly (P<0.05) affect instent restenosis.

Conclusion: Wingspan stenting in the intracranial vertebral artery atherosclerotic stenosis combined with contralateral vertebral artery atherosclerotic diseases has a low perioperative stroke rate and a good preventive effect on long-term ischemic stroke, but the instent restenosis rate is a little high.

Keywords: Atherosclerotic stenosis; Contralateral vertebral disease; Instent restenosis; Intracranial vertebral artery; Wingspan stent.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction
  • Atherosclerosis / complications
  • Atherosclerosis / diagnosis
  • Atherosclerosis / surgery
  • Cerebral Angiography
  • China
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Arteriosclerosis / complications
  • Intracranial Arteriosclerosis / diagnosis
  • Intracranial Arteriosclerosis / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prospective Studies
  • Stents / statistics & numerical data*
  • Stroke / prevention & control
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / pathology
  • Vertebral Artery / surgery
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / diagnosis
  • Vertebrobasilar Insufficiency / surgery*
  • Young Adult