The utility of drug-eluting stent in the treatment of posterior circulation artery stenosis

Objective: To evaluate the safety and efficacy of drug-eluting stent in the treatment of posterior circulation artery stenosis. Methods: 19 patients (19/30)with extra or intracranial vertebral artery stenosis diagnosed by angiography received drug-eluting stent place ment after anticoagulation therapy. The Seldinger technique was used to insert the 6 F sheath into the right femoral artery under local or general anesthesia. After set up of guide wire the 6 F guiding catheter was introduced into the subclavian artery at the origination point of vertebral artery and then the micro-guide-wire of 0.014in, 300 cm or 205 cm reached at the distal part of stenosis through the guiding catheter. The correlated balloon expandable stent Cypher or TAXUSTM was successfully deployed and postdilation was performed if necessary. Results: All the procedures were succeeded without mortality and any complications. The stents showed good coherence to the vessels wall without any separation and the blood flow improved greatly as the distal branch arteries completely opacified by angiography. The proportion of stenosis decreased from 87.5% to 5.2%. The vertigo disappeared in twelve cases (12/15) and improved in three cases (3/15). 6 patients with manifestation of ataxia, recovered to normal in 4 and the other two improved obviously. One patient with cerebella dysphasia improved conspicuously after stenting. No less than 15 cases were followed up by secondary angiography and others were followed up clinically. Conclusions: The preliminary application of drug-eluting stent in the treatment of posterior circulation artery stenosis seems to be safety and efficient with prevention of the arterial from restenosis. However, further large scale and randomized study should be carried out in need. (authors)