Endovascular treatment in orificial occlusive lesions of vertebral artery

Abstract

Objectives: Vertebral artery (VA) stenosis is found in 20%of patients with posterior fossa ischemia. Endovasculartreatment has become more preferable to be used in thetreatment of VA orificial occlusive lesions referring to therecent developments. In this study, we aimed to present theclinical results and to show the success of the endovasculartreatment in occlusive lesions localized in VA orifice.Materials and Methods: In our retrospective study, 28patients undergoing endovascular intervention between2010 and 2013 for symptomatic occlusive lesion in VAorifice were examined. The patients were diagnosed withDoppler ultrasonography, following extensive neurologicalexamination. Consequently, stent implantation with digitalsubtraction angiography device was applied in interventionalradiology unit. Demographical, angiographical, clinicalinformation of subjects, as well as data regarding thestenosis before and after the procedure were recorded.Results: Endovascular treatment was applied to 19patients with left vertebral (67.8%), eight patients withright vertebral (28.5%), and one patient with left and rightvertebral lesions (3.5%). Technical success rate was 100%.One total occlusion (3.5%), three 95% to 99% stenosis(10.5%) and one 70% stenosis were seen during follow-up.Among the patients, two with 95% to 99% stenosis weretreated endovascularly again. In early (0-3 months) term,primary and secondary patency rate was 100%. For mid-(4-6 months) term, primary and secondary patency was96.4%. At long term, primary and secondary rates were86.9% and 91.3%, respectively.Conclusion: Endovascular treatment, combined withoptimal medical therapy, is an effective treatment methodin orificial occlusive lesions of VA.