Clinical Report: Self-Expanding Open-Cell Carotid Stents for VAO Stenosis

Overview

This study evaluates the safety and feasibility of open-cell self-expanding stents in patients with symptomatic moderate to severe atherosclerotic stenosis at the vertebral artery origin (VAO).

Background

Atherosclerotic stenosis at the VAO is a significant cause of posterior circulation ischemic events, which can lead to recurrent ischemic symptoms despite optimal medical therapy. Endovascular stenting presents a less invasive alternative to surgical reconstruction.

Data Highlights

Key Findings

• Technical success of open-cell self-expanding stent implantation was 100%.
• VAO stenosis improved significantly from 75.7% pre-procedure to 8.4% post-procedure (p < 0.001).
• Periprocedural complications occurred in 5.9% of patients, including one case of symptomatic acute cerebral infarction.
• No myocardial infarction or death occurred within 30 days post-procedure.
• Long-term follow-up showed no treatment-requiring recurrent symptoms in 91.2% of patients.
• In-stent restenosis (ISR) was observed in 6.3% of patients with DSA follow-up and 4.2% among all patients with imaging surveillance.

Clinical Implications

Further studies are needed to confirm long-term durability and optimal patient selection.

Conclusion

Open-cell self-expanding stent implantation for atherosclerotic VAO stenosis is a technically feasible procedure with infrequent periprocedural adverse events.

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