Сlinical and instrumental evaluation of vertebral arteries stenting efficiency in the short-term and long-term postoperative periods

Abstract

Objective: to evaluate the effectiveness of transluminal angioplasty with stenting in the treatment of atherosclerotic stenosis of the vertebral arteries (VA) proximal segment. Materials and methods. One hundred twenty-seven patients (97 men and 30 women, mean age 60 years) with symptomatic (72% of patients) and asymptomatic (28% of patients) stenosis of the VA were examined, the degree of stenosis according to X-ray angiography was 7611%. One hundred fifteen (91%) patients with 127 (91%) implanted stents were surveyed over time (average follow-up time 13 months). Results. Technical success was achieved in 94% of cases. In the perioperative period, no acute cerebrovascular events, myocardial infarctions or deaths were registered. Recurrence of symptoms of vertebrobasilar insufficiency was noted in 14% initially symptomatic patients. According to ultrasound study data, restenosis 50% or reocclusion of the VA stent was detected in 40% cases. Damage to the integrity of the stent was diagnosed in 8% cases, which in all observations was combined with restenosis. Repeated derangement of stent patency after restenting of 11 VA in the period of 46 months was revealed in 60% of cases (2 reocclusions and 4 restenoses). Conclusion. Angioplasty with stenting is a safe and clinically effective method for treating atherosclerotic stenosis of the proximal segment of VA. In a cohort of 50 patients included in the study, low quality of life was observed prior to stenting of VA. Six months after the VA stenting, the quality of life of patients increasesin both physical and psychological aspects. The main problem remains to be a high incidence of restenosis or reocclusion of stents after primary and repeated endovascular intervention in the long-term postoperative period.

Keywords

• atherosclerosis of vertebral arteries
• insufficient blood flow in the arteries of the vertebrobasilar system
• endovascular treatment
• stents
• restenosis