Abstract Details

Title : Vertebral artery origin stenosis: systematic review of randomized clinical trials

Topic Cerebrovascular Disease and Interventional Neurology

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

Poster/Presentation
Number 3-038

Objective

To examine the safety and effectiveness of advances in the endovascular management of vertebral artery origin stenosis(VAOS).

Background

VAOS accounts for approximately 20% of posterior circulation stroke and is associated with high risk of early stroke recurrence. VAOS sometimes escape detection as it is easier to pursue other potential stroke causes. Recent advances can potentially enhance management and treatment of VAOS.

Design/Methods

Medline, Science Direct & Academic Search Complete were searched for articles on latest advances in the management of VAOS, published from 2000 to 2017. We selected articles using the following entry criteria: randomized, controlled with active and control groups receiving treatment for VAOS. Conference abstracts and review papers were excluded.

Results The literature search identified 540 articles, 5 articles fulfilled the inclusion and exclusion criteria. The articles reported on 5 RCTs and included a total of 652 participants of which 70% were males with a mean age of 63 years. 3 RCTs had a mean follow-up period of 3 years, another for 24 months, while 1 RCT followed patients for 12 months. 3 RCTs reported data on the outcome of fatal or nonfatal stroke within 30 days among a combined total of 11 patients. Over the follow-up years,1 RCT reported stroke rates of 34% in patients with stenting, 2 RCTs reported rates of 21% and another in 12% of the patient population.1 RCT reported a relative risk reduction of 20% by stenting for vertebrobasilar stroke, while another RCT reported a non-significant 60% lower risk of fatal & nonfatal stroke.

Conclusions Findings supports the feasibility, safety & effectiveness of stenting. However, the long-term outcomes and rate of restenosis, clinical recurrence and potential complications associated with stenting remains vague. Definitive evidence of stenting as the optimal treatment for VAOS was mixed. Further investigation with multicenter randomized trials comparing new advances in the management of VAOS are needed.

Authors/Disclosures
Chizoba Ezepue, MD (SSM health DePaul Hospital) PRESENTER	No disclosure on file
Randall Edgell, MD	Dr. Edgell has nothing to disclose.
	No disclosure on file

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