Our Experiences with Vertebral Artery Stents

Abstract

Objective: This study aimed to evaluate the success and clinical outcomes of endovascular stent treatment in vertebral artery (VA)occlusive lesions.Methods: A total of 103 patients who underwent endovascular treatment due to VA constriction were included in this study. Thepatients were diagnosed on the basis of their clinical manifestations (vertigo, visual complaints, syncope, ataxia, drop attack, isch-emic stroke, and transient ischemic attack (TIA)), neurological examinations, Doppler ultrasonography examination, and digitalsubtraction angiography (DSA). For angiographic evaluation, all patients underwent four vessel angiographies including the aorticarch, VA, and carotid artery. Anterior circulation, posterior circulation, and the Willis polygon were evaluated for all patients. Duringthe procedure, the patients were not sedated, and neurological findings were continuously monitored.Results: Thirty-six patients had stents implanted in their right vertebral arteries, 16 patients in their left vertebral arteries, and 3patients in both vertebral arteries. During the procedure, bradycardia developed in three cases, and atropine was administered forits intervention. Hypotension developed in two cases, and dopamine along with 0.9% NaCl was administered for its intervention.One of the patients developed a speech disorder along with a complaint of imbalance 24 hours after the procedure. A magneticresonance imaging (MRI) examination revealed an infarct on the left posterior inferior cerebellar artery (PICA) supply area. Thepatients’ symptoms subsided with minimal sequelae. Two patients had TIAs with complaints of dizziness and weakness on the leftside. Hemorrhage and hematoma developed in the femoral artery region 2 hours after the stent implantation in two cases. Oneunit transfusion was applied.Conclusion: Vertebral artery stenosis is one of the correctable causes of posterior systemic stroke and can now be diagnosed withmore ease with the use of modern imaging methods. Balloon angioplasty or stent-assisted endovascular treatment is an effectivetreatment with low morbidity and mortality for patients with a single VA or who do not respond to medical treatment due tocerebral vascular pathology.