Article Text

Download PDFPDF
Vertebral artery origin angioplasty and primary stenting: safety and restenosis rates in a prospective series
  1. G C Cloud1,
  2. F Crawley3,
  3. A Clifton2,
  4. D J H McCabe3,
  5. M M Brown3,
  6. H S Markus1
  1. 1Division of Clinical Neuroscience, St George’s Hospital Medical School, London SW17 0RE, UK
  2. 2Department of Neuroradiology, Atkinson Morley’s Hospital, London SW20 0NE
  3. 3Institute of Neurology, University College London, London WC1N 3BG
  1. Correspondence to:
 Professor Hugh Markus, Division of Clinical Neuroscience, St George’s Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK; 


Objectives: To report a single centre ongoing experience of endovascular treatment for atherosclerotic vertebral artery origin stenosis in a series of symptomatic patients, with follow up imaging to determine the incidence of restenosis.

Methods: 14 patients with vertebral artery origin stenosis on catheter angiography were treated. Angioplasty without stenting was undertaken in the first four patients, all of whom had follow up catheter angiography at one year. Subsequently, patients were treated by primary stenting and followed up with colour Doppler ultrasound examination.

Results: The procedure was technically successful in all treated arteries, with no immediate complications. The degree of stenosis was reduced from (mean (SD)) 73 (18)% before treatment to 21 (26)% immediately after treatment in the angioplasty alone group (p = 0.059). In the primary stenting patients, the severity of stenosis was reduced from 82 (8)% to 13 (13)% immediately after treatment (p < 0.001). Restenosis to 70% or greater occurred at one year in all four patients initially treated by angioplasty without stenting. One patient subsequently developed further symptoms and was retreated by stenting. One of the 10 patients treated by primary stenting developed restenosis. None of the remaining patients had further posterior circulation ischaemic symptoms during a mean follow up period of 33.6 months (range 1 to 72 months).

Conclusions: Restenosis occurs often after vertebral artery origin balloon angioplasty without stenting but is uncommon after stenting. Primary stenting is therefore recommended to maintain patency at this site, and had a low complication rate in this series.

  • angioplasty
  • stenting
  • vertebral artery
  • stroke prevention

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: MMB has received travel reimbursements for attending conferences from Boston Scientific and research grant funding, speakers fees and educational fees from Sanofi-Synthelabo. None of the other authors has competing interest to declare.