Endovascular Treatment in Orificial Occlusive Lesions of Vertebral Artery

Objectives: Vertebral artery (VA) stenosis is found in 20% of patients with posterior fossa ischemia. Endovascular treatment has become more preferable to be used in the treatment of VA orificial occlusive lesions referring to the recent developments. In this study, we aimed to present the clinical results and to show the success of the endovascular treatment in occlusive lesions localized in VA orifice. Materials and Methods: In our retrospective study, 28 patients undergoing endovascular intervention between 2010 and 2013 for symptomatic occlusive lesion in VA orifice were examined. The patients were diagnosed with Doppler ultrasonography, following extensive neurological examination. Consequently, stent implantation with digital subtraction angiography device was applied in interventional radiology unit. Demographical, angiographical, clinical information of subjects, as well as data regarding the stenosis before and after the procedure were recorded. Results: Endovascular treatment was applied to 19 patients with left vertebral (67.8%), eight patients with right vertebral (28.5%), and one patient with left and right vertebral 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 were treated 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 was 96.4%. At long term, primary and secondary rates were 86.9% and 91.3%, respectively. Conclusion: Endovascular treatment, combined with optimal medical therapy, is an effective treatment method in orificial occlusive lesions of VA. Keywords: Vertebral artery, stenosis, endovascular treatment, stent