Clinical Trial Of The Treatment Of Ostial Vertebral Artery Stenosis(OVAS) With Double-stent Implantation

Objective: To investigate the safety and effectiveness of double-stent implantation in the treatment of atherosclerotic ostial vertebral artery stenosis(OVAS).Methods: Retrospectively collected and analysis the data(general information,risk factors of vascular disease,symptom progress records,vascular imaging test results)of patients,whom were diagnosed of OVAS(stenosis rate≥50%)by digital cerebral angiography(DSA)and accepted the double-stent implantation in the Department of Neurology,the First Affiliated Hospital of Guangxi Medical University from January 2014 to September 2019.Results:(1)A total of 31 patients(29 males and 2 females)were included in the study,with an average age of 63.06±10.75 years,of which the minimum age was 43 years and the maximum age was 85 years.62 stents were placed(technical success rate is 100%).Double-stent placement was used to treat 21cases(67.7%)of left vertebral artery stenosis and 10 cases(32.3%)of right side.(2)The preoperative stenosis rate was(74.35±11.39)%,and the immediate postoperative residual stenosis rate was(8.10±3.81)%,which was significantly lower than that before operation(t=40.99,P<0.01);no hyperperfusion and postoperative neurological function deteriorated associated with stent implantation was found;of the 30 patients with symptomatic stenosis,25patients(83.33%)had symptoms relieved when discharged from the hospital.(3)29 patients have been reexamined,the reexamination time is 5-19 months,the median reexamination time is 7(6.5,10)months;26 cases(89.66%)were reviewed by CTA,3 cases(10.34%)were reviewed by DSA;restenosis was found in 1 patient(3.45%).The residual stenosis rate ranged from 15% to 68%,and the median stenosis rate was 18%(16%,20%).Of the 28 patients with symptomatic stenosis,1 patient(3.57%)had his dizziness worsen,and restenosis was confirmed by CTA,and 25(89.29%)had symptoms relieved.Conclusion: Double-stent placement is safe and effective,it can effectively expand the stenosis of,and improve the posterior circulation ischemic symptom of patients in the short term,and the incidence of restenosis in the short term is low.Long-term efficacy needs further investigation.Double-stent placement can safely and effectively treat atherosclerotic stenosis of the ostial vertebral artery,and improve the clinical symptoms of patients.Whether its efficacy is better than traditional surgery still needs further investigation.