Drug-eluting vs. bare metal stents for symptomatic vertebral artery stenosis.

Abstract

PURPOSE:

To evaluate the immediate and long-term outcomes of drug-eluting stent (DES) vs. bare metal stent (BMS) for symptomatic vertebral artery stenosis (VAS).

METHODS:

From 2003 to 2010, 206 consecutive patients (158 men; mean age 66.8 years) underwent DES (sirolimus-eluting or paclitaxel-eluting) or BMS placement for symptomatic extracranial and intracranial stenoses in 219 vertebral arteries. The technical success, clinical success, periprocedural complications, target vessel revascularization (TVR), and overall survival were compared between the DES and BMS groups.

RESULTS:

The technical success rate was 98.3% (119/121) for the DES group vs. 100% for the BMS group (p = 0.503). The clinical success rate was 95.5% (107/112) for the DES group vs. 97.9% (92/94) for the BMS group (p = 0.592). No periprocedural death or stroke occurred. The overall periprocedural complication rate was 2.7% (3/112) in the DES group vs. 4.3% (4/94) in BMS group (p = 0.813). The median follow-up was 43 months (range 3-95) for the DES group and 46 months (range 6-89) for BMS. At last follow-up, the TVR rate was 6.3% (7/112) for the DES group vs. 20.2% (19/94) for the BMS group (p = 0.003); 4 (3.6%) patients in the DES group and 8 (8.5%) patients in the BMS group experienced a VBS stroke (p = 0.132). By life-table analysis, the 5-year TVR rate was 4.5% (5/112) for the DES group vs. 19.1% (18/94) for the BMS group (p = 0.001). No difference was detected in the overall survival curves between the groups (p = 0.500).

CONCLUSION:

Both DES and BMS are feasible, safe, and effective for symptomatic VAS. However, DES can significantly decrease the TVR rate in the long term compared with BMS.

• Authors: Lipo Song, Jianxin Li, Yongquan Gu, Hengxi Yu, Bing Chen, Lianrui Guo, Jian Zhang
• Journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 19 Issue 2 Pg. 231-8 (Apr 2012) ISSN: 1545-1550 [Electronic] United States
• PMID: 22545889 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Cardiovascular Agents
• Metals
• Paclitaxel
• Sirolimus

Topics

• Aged
• Cardiovascular Agents (administration & dosage)
• Cerebral Angiography
• China
• Drug-Eluting Stents
• Endovascular Procedures (adverse effects, instrumentation, mortality)
• Female
• Humans
• Male
• Metals
• Middle Aged
• Multivariate Analysis
• Paclitaxel (administration & dosage)
• Proportional Hazards Models
• Prosthesis Design
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Sirolimus (administration & dosage)
• Stents
• Stroke (etiology)
• Survival Analysis
• Time Factors
• Treatment Outcome
• Vertebrobasilar Insufficiency (complications, diagnostic imaging, mortality, therapy)