Usefulness of Drug-Eluting Stents in Angioplasty and Stenting of the Vertebral Artery Origin : Comparison with Bare Stents: Clinical Research

Kim, Jin Sung; You, Seung Hoon; Kim, Seong Rim; Kim, Sang Don; Kim, Young Woo; Park, Ik Seong; Baik, Min Woo; Kim, Moon Chan

Abstract

OBJECT: In the treatment of coronary atherosclerosis, drug-eluting stents are effective in decreasing the rate of major adverse cardiac events and angiographic restenosis compared with bare metal stents. However, the benefits and safety of using these new devices in the cerebral vasculature have not been evaluated. To assess the effectiveness of drug-eluting stents in the cerebral vasculature, the authors analyzed clinical and angiographic results after percutaneous transluminal angioplasty and stenting in patients with vertebral artery origin stenosis.
METHODS
Ninety-one patients with 99 vertebral origin stenoses treated with percutaneous endovascular balloon angioplasty and stent placement during a period of 5.1 years (September 1999-October 2004). Follow-up angiograms were obtained from 38 patients with 42 lesions (24 men, 14 women ; mean age, 61.9 yrs ; mean follow-up period, 9.1 months). We reviewed the clinical and radiological records of these patients.
RESULTS
Bare stents were implanted in 30 lesions, while drug-eluting stents were implanted in 12 lesions, with a mean residual stenosis of 5.1 %. The overall rate of moderate-to-severe restenosis (> or =50%) was 31.0 % (13 of 42 cases). The restenosis rate in the bare stent group was 36.7 %, compared with 16.7 % in the drug-eluting stent group (p=0.282). Comparing the restenosis rate in stented lesions with reference diameters less than 3.5 mm (11 with bare stents, 12 with drug-eluting stents), the restenosis rates were 63.6 % in the bare stent-group and 16.7 % in the drug-eluting stent-group (p=0.029).
CONCLUSION
Drug-eluting stents placed in vertebral artery origin stenosis have lower restenosis rate than bare stents, particularly in small-sized vessels.