Risk Factors for Restenosis After Stenting or Angioplasty of Vertebral Artery Origin

Results of Short-term and Long-term Follow-up


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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Balloon-assisted angioplasty


Bare metal stents


Best medical therapy


Color Doppler ultrasound


C-reactive protein


Computed tomography


Computed tomography angiography


Digital subtraction angiography


Drug-eluting stent


Magnetic resonance


Magnetic resonance angiography


North American Symptomatic Carotid Endarterectomy Trial


Percutaneous transluminal angioplasty


Stent-assisted angioplasty


Transient ischemic attack


Vertebral artery


Vertebral artery origin


Vertebral Artery Stenting Trial


Vertebral Artery Ischaemia Stenting Trial


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Corresponding author

Correspondence to Malgorzata Wolska-Krawczyk.

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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

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  • BMI
  • Ostium
  • Overweight
  • Stenosis
  • Follow-up