Abstract
INTRODUCTION:Endovascular management of vertebral artery stenosis in patients with recurrent cerebral infarction remains a topic with multiple gaps in knowledge because of poor scientific evidence is available today.
REPORT OF CASES:Here are reported two typical cases of cerebral infarction recurrence due to vertebral artery stenosis managed with new endovascular devices (balloon-expandable-stent medicated with zotaroli-mus), with satisfactory clinical and neuroimaging outcomes. Herein it is described the technique used and the angiographic findings are illustrated.
CONCLUSION:In light of new devices and neurointerventional techniques, we consider that it should be done a careful and individual evaluation of patients with vertebral stenosis and stroke recurrence despite an optimized medical management. It is still required more studies that allow future consistency in the selection of patients and decision making.
References
Pradilla A G, Yesga A BE, León-Sarmiento FE, Grupo Geneco. National neuroepidemiological study in Colombia (Epineuro). Rev Panam Salud Publica. 2003;14(2):104-11.
Mohr JP, Thompson JL, Lazar RM, Levin ?, Sacco RI, Furie KL, Kistler JP, et al. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med. 2001;345(20):1444-51.
Chimowitz MI, Kokkinos J, Strong J The Warfarin-Aspirin Symptomatic Intracranial Disease Study. Neurology. 1995;45(8):1488-93.
Zaidat OO, Fitzsimmons BF, Woodward BK, Wang Z, Killer-Oberpfalzer M, Wakhloo A, Gupta R, et al. Effect of a a balloon-expandable intracranial stent vs medical therapy on risk of stroke in patients with symptomatic intracranial stenosis: the YISSIT randomized clinical trial. JAMA. 2015;313(12):1240-8.
Chimowitz M, Lynn M, Derdeyn C, et al., Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis N Engl J Med 2011;365:993-1003
Markus HS, Larsson SC, Kuker W Schulz UG, Ford I, Rothwell PM, Clifton A, et al. Stenting for symptomatic vertebral artery stenosis: The vertebral artery ischaemia stenting trial. Neurology. 2017;89(12):1229-36.
Ferguson GG, Eliasziw M, Barr HW The North American Symptomatic Carotid Endarterectomy Trial: Surgical results in 1415 patients. Stroke. 1999;30(9):1751-8.
Heit JJ, Wong JH, Mofaff AM, Telischak NA, Dodd RI, Marks MP, Do HM. Sofia intermediate catheter and the SNAKE technique: safety and efficacy of the Sofia catheter without guidewire or microcatheter construct. J Neurointerv Surg. 2018;10(4):401-6.
Yeh RW, Silber S, Chen L, Chen S, Hiremath S, Neumann FJ, Qiao S, et al. 5-year safety and efficacy of resolute zotarolimus-eluting stent: The Resolute Global Clinical Trial Program. JACC Cardiovasc Interv. 2017;10(3):247-54.
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