3^rd World Heart Congress

Biography

Biography: Vijaya Pamidimukkala

Abstract

Extracranial vertebral artey stenosis is common in patients with posterior circulation ischaemic stroke. In our high volume stroke centre, we analysed the data of symtomatic extracranial vertebral artery stenosis treated with angioplasty from 2003 to 2013. Total 284 patients underwent vertebral angioplasty and were followed up and analysed. Inclusion criteria were: recent ipsilateral posterior circulation stroke, recurrent posterior circulation tias with documented critical vertebral artery stenosis at the origin. Patients with associated critical carotid stenosis and intracranial vertebral stenosis were excluded. Mean age of patients was 58±8 years and 72% were males. Of total, 56% were diabetic, 48% were hypertensive, 58% had coronary artey disease, 38% were smokers. All procedures were performed using standard percutaneous angioplasty protocol. Transfemoral route was approched in 94% procedures. Dual antiplatelets (aspirin 150 mg OD and clopidogrel 75 mg BD) and statins were given. Fifty-six patients received bare metal stents (BMS) and remaining received drug-eluting stents (DES). Mean follow-up of 2.5 years (1-6 years), was performed with clinical and doppler studies. Procedural success was 99.5%. Two patients had femoral hematoma. No major periprocedural complication like stroke or myocardial infarction (MI) or death were observed. Restenosis occurred in 4 patients (3 in BMS group; 1 in DES group). One patient had basilar stroke after 6 months and 2 patients had MI, of which 1 patient died. In conclusion, angioplasty with stenting of extracranial vertebral artery is safe procedure with very high success rate and good clinical outcome. However, further randomised trials should be held on treatment of extracranial vertebral stenosis