Treatment of Vertebral Artery Origin Stenosis with Anti-Proliferative Drug-Eluting Stents

ABSTRACT BACKGROUND Vertebral artery origin stenosis is a known cause of stroke that is treatable with angioplasty and stenting. Previous studies have demonstrated that this technique is safe but is limited by high rates of in‐stent stenosis. Anti‐proliferative drug‐eluting stents are an alternative for reducing in‐stent stenosis at the vertebral artery origin. METHODS This retrospective study included five consecutive patients treated with anti‐proliferative drug‐eluting stents. The patients' demographics, indications for treatment, procedural technique, and clinical and radiographic follow‐up are presented along with a review of the literature. RESULTS No peri‐procedural complications occurred. One patient had a transient ischemic attack (TIA) during the follow‐up period. No patients had hemodynamically significant (>50%) in‐stent stenosis at follow‐up. Among the 287 cases reported in the literature, there were two strokes (.7%), four TIAs (1.4%), and no procedurally related deaths. Among patients undergoing angiographic follow‐up, 26% were found to have >50% in‐stent stenosis. CONCLUSIONS Anti‐proliferative drug‐eluting stents hold promise for reducing in‐stent stenosis at the vertebral artery origin.