Abstract Details

Title Second Generation Drug-Eluting Stents for Endovascular Treatment of Ostial Vertebral Artery Stenosis: A Single-Center Experience

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-037

Objective To report a single-center experience using second generation drug-eluting balloon mounted stents (DES) for endovascular treatment of atherosclerotic ostial vertebral artery stenosis (OVAS).

Background Posterior circulation is affected in up to 25% of strokes, 20% of them resulting from atherosclerotic OVAS. The optimal management of OVAS has not been well-defined. The use of DES has been introduced to improve safety outcomes and restenosis rates.

Design/Methods We prospectively collected data of patients with dominant OVAS who underwent endovascular treatment with second generation DES placement. Patient demographics, clinical presentation, comorbidities, stenosis severity, stent features, technical success, complications and imaging follow-up were assessed. All patients received dual antiplatelet therapy for one year.

Results Thirty patients were treated and were predominantly male (n=25). Six patients presented as stroke, ten as TIA and twenty-three were treated on an elective basis due to contralateral occlusion. Main comorbidities included hyperlipidemia (82.7%), hypertension (80%) and prior stroke (63.3%). Mean ostium stenosis at presentation was 80±14.8%. 23/30 had contralateral VA involvement. DES deployment was technically successful in all patients using everolimus in 30 lesions and zotarolimus in two. Three (10%) periprocedural complications occurred but only one (3.3%) was directly related to DES placement. Complications included one stent migration, one small ischemic infarct in the posterior circulation, and a femoral artery thrombosis. Twenty five patients have had imaging follow-up (mean of 10.3 months). Two (6.6%) patients presented in-stent restenosis and underwent angioplasty retreatment. There were no procedure-related mortalities.

Conclusions Our study confirms the feasibility of deploying DES for the treatment of ostial vertebral artery stenosis, with minimal technical challenge and a low rate of periprocedural morbidity.

Authors/Disclosures
Aldo Mendez Ruiz, MD (University of Pittsburgh Medical center) PRESENTER	No disclosure on file
Gloria V. Lopez Cardenas, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Sudeepta Dandapat, MD (Aurora Neurosciences Innovation Institute)	Dr. Dandapat has nothing to disclose.
Edgar Samaniego, MD, FAAN (University of Iowa Hospital and Clinics)	Dr. Samaniego has received personal compensation for serving as an employee of University of Iowa. Dr. Samaniego has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Terumo Neuro. Dr. Samaniego has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Rapid Medical. Dr. Samaniego has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for J&J Neuro. Dr. Samaniego has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Metronic. Dr. Samaniego has received personal compensation in the range of $0-$499 for serving as a Consultant for iSchemaView. Dr. Samaniego has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Society of Neurointerventional Surgery. Dr. Samaniego has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neurointerventional Surgery.
	No disclosure on file

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