Background and Purpose
Endovascular treatment represents a well-established therapeutic option in patients with vertebral artery origin (VAO) stenosis. Our aim was to determine which factors affect short- and long-term restenosis rates after endovascular VAO therapy.
We conducted a single center analysis of 52 patients (36 men; age 64 ± 9.54 years) who underwent 55 endovascular procedures (27 balloon-assisted angioplasty [BAA], 28 stent-assisted angioplasty [SAA]) between 2005–2015. We collected data on patients clinical characteristics, medication and post-interventional follow-up visits.
Overall, 15 of 55 vessels (27%) showed ≥70% restenosis at 1 year (short-term follow-up) and 18 after a mean follow-up of 52.9 ± 31.8 months (long-term). BMI ≥ 25 kg/m2 was associated with ≥70% restenosis in short-term (P = 0.014) and long-term (P = 0.003) follow-up. Other risk factors, namely, hypertension, ischemic heart disease, smoking, diabetes mellitus, hypercholesterolemia, atrial fibrillation, CRP (>5 mg/l) or pre-treatment antiplatelet administration, statin intake and platelet count, were not associated with restenosis risk in the entire cohort or in patients in the BAA group (all P > 0.05). BMI (P = 0.003) and ischemic heart disease (P = 0.041) were, in turn, associated with restenosis risk in the long-term follow-up in the SAA group. Patients undergoing BAA developed less frequently (P = 0.032) restenosis (18%) during long-term follow-up as compared to patients treated by stenting (46%).
BMI ≥ 25 kg/m2 increases the odds for ≥70% restenosis of VAO while ischemic heart disease represents an additional risk factor in stented patients. Further studies are required to established therapeutic strategies lowering the restenosis rates in overweight individuals after VAO therapy, especially ones undergoing stenting.
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Bare metal stents
Best medical therapy
Color Doppler ultrasound
Computed tomography angiography
Digital subtraction angiography
Magnetic resonance angiography
North American Symptomatic Carotid Endarterectomy Trial
Percutaneous transluminal angioplasty
Transient ischemic attack
Vertebral artery origin
Vertebral Artery Stenting Trial
Vertebral Artery Ischaemia Stenting Trial
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Conflict of interest
M. Wolska-Krawczyk, M. Drunck, S. Behnke and W. Reith declare that they have no competing interests.
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Wolska-Krawczyk, M., Drunck, M., Behnke, S. et al. Risk Factors for Restenosis After Stenting or Angioplasty of Vertebral Artery Origin. Clin Neuroradiol 30, 355–362 (2020). https://doi.org/10.1007/s00062-019-00768-2