Drug-eluting stents in the treatment of proximal vertebral artery stenosis

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• 作者：A. O. Chechetkin ; S. I. Skrylev ; A. Yu. Koshcheev ; V. L. Shchipakin&#8230
• 关键词：vertebral artery stenosis ; endovascular treatment ; drug ; eluting stents ; restenosis
• 刊名：Human Physiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：42
• 期：8
• 页码：837-843
• 全文大小：<len>
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Life Sciences, general; Human Physiology; Biomedicine, general;
• 出版者：Pleiades Publishing
• ISSN：1608-3164
• 卷排序：42

文摘

The objective of the study was to evaluate the efficacy of endovascular revascularization treatment using drug-eluting stents in patients with atherosclerotic proximal vertebral artery (VA) stenosis. Thirty-two patients (61 ± 10 years old) were implanted with 35 sirolimus and tacrolimus eluting stents (3 patients had them from two sides). 27 patients (84%) had vertebrobasilar symptoms at enrollment. All patients were pretreated with dual antiplatelet therapy. The intervention was technically successful in 89% cases. No stroke, myocardial infarction, or death occurred in perioperative period. On duplex scanning the stents remained completely functional. In the late postoperative period 29 (91%) patients, with 32 implanted stents were followed- up. The mean follow-up was 9.5 months. No stroke occurred in patients during this period. Recurrence of vertebrobasilar insufficiency symptoms was noted in 3 patients. VA renarrowing was detected in 16 (50%) arteries in 15 patients, and 12 (80%) of them were asymptomatic. Restenosis ≥50% (n = 13) and reocclusion (n = 3) were more frequent in those with implantation of tacrolimus eluting stents compared to those with sirolimus eluting stents: 10 (71%) of 14 observations to 6 (33%) of 18 cases (p = 0.1794), respectively. Stent fracture was observed in 2 cases (6%), followed by restenosis. Restenosis rate prevailed in men (p = 0.0173). Thus, stenting of VA extracranial portion is reasonably safe procedure with a good clinical effect. The use of drug-eluting stents looks promising but does not solve the problem of high restenosis rate in the late postoperative period.