Document Detail


Restenosis rates following vertebral artery origin stenting: does stent type make a difference?
MedLine Citation:
PMID:  20197579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare our experience with sirolimus and paclitaxel-eluting stents (drug-eluting stents [DES]) and non-drug-eluting stents (NDES) for treatment of vertebral artery (VA) origin stenosis and review the literature. METHODS: A retrospective review of our prospectively collected database was performed. Clinical and radiologic follow up was obtained by reviewing office records and radiology. Data collected included demographics, comorbidities, presenting symptoms, stenosis severity, contralateral VA stenosis and/or carotid stenosis, type of stent used, angioplasty before or after stenting, post-treatment residual stenosis, clinical and radiological follow up and retreatment. Patients with symptomatic > 60% stenosis or asymptomatic > 70% stenosis and/or a hypoplastic or occluded contralateral VA or significant carotid occlusion were chosen for revascularization. RESULTS: Thirty-five patients treated with NDES and 15 treated with DES for management of VA origin stenosis were identified. The technical success rate of the procedure was 100%. There were no procedural complications. There were 7 asymptomatic patients (NDES Group-4, DES Group-3). In the NDES Group, 9 patients had pre-stent angioplasty; 2 had post-stent angioplasty. In the DES group, 4 patients had post-stent angioplasty. Symptoms resolved in 30/31 (96.8%) patients treated with NDES and 11/12 (91.7%) treated with DES. Thirty-six patients had radiologic follow up (median 21.3 months); in-stent restenosis was documented in 11 patients (NDES 9/24 [38%], DES 2/12 [17%]). Among patients receiving NDES, re-stenotic lesions required angioplasty in 7 patients. No patients in the DES group required angioplasty. CONCLUSIONS: DES for treatment of VA origin stenosis may decrease the incidence of restenosis when compared to NDES. Validation in prospective, randomized, multicenter trials is necessary.
Authors:
Christopher S Ogilvy; Xinyu Yang; Sabareesh K Natarajan; Erik F Hauck; Luona Sun; Laura Lewis-Mason; L Nelson Hopkins; Adnan H Siddiqui; Elad I Levy
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-03     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  119-24     Citation Subset:  IM    
Affiliation:
Neurovascular Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. cogilvy@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon / instrumentation,  methods*
Drug-Eluting Stents*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Paclitaxel
Recurrence / prevention & control
Retrospective Studies
Sirolimus
Stents*
Treatment Outcome
Vertebrobasilar Insufficiency / prevention & control*,  therapy*
Chemical
Reg. No./Substance:
33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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