To evaluate the feasibility, periprocedural safety, and follow-up outcomes of open-cell self-expanding stent implantation for moderate-to-severe atherosclerotic stenosis at the vertebral artery origin (VAO).
Approach:
Study Design: A single-center retrospective study was conducted at Beijing Chaoyang Hospital, reviewing 96 patients evaluated for open-cell self-expanding stent treatment of angiographically confirmed VAO stenosis.
Patient Selection: 34 symptomatic patients with a target vertebral artery diameter >= 4.0 mm underwent stent implantation after excluding 62 patients.
Outcome Assessment: Clinical outcomes were assessed perioperatively and during follow-up, focusing on the 30-day safety endpoint and in-stent restenosis (ISR).
Key Findings:
Technical success rate was 100%.
VAO stenosis improved from 75.7% pre-procedure to 8.4% post-stenting (p < 0.001).
Periprocedural complications occurred in 2 out of 34 patients (5.9%), including 1 symptomatic acute cerebral infarction.
No myocardial infarction or death occurred within 30 days.
Long-term follow-up showed no treatment-requiring recurrent symptoms in 31 patients, with ISR confirmed in 1 out of 16 patients (6.3%).
Interpretation:
Limitations:
The study is retrospective and conducted at a single center.
The sample size is small, limiting generalizability.
Longer-term durability and optimal patient selection require confirmation in larger prospective studies.
Conclusion:
Open-cell self-expanding stent implantation for atherosclerotic VAO stenosis is associated with infrequent adverse events.
