ArticleFrontiers in aging neuroscience2025
Safety and efficacy of extracranial vertebral artery stenting in elderly patients with symptomatic vertebral artery stenosis.
Article in Frontiers in aging neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Symptomatic stenosis of the extracranial vertebral artery is an important cause of posterior circulation stroke. Endovascular stenting has shown promise for these lesions, but evidence in patients aged ≥ 70 years is limited. This study assessed perioperative safety and intermediate-term efficacy of extracranial vertebral artery stenting in elderly patients (≥70 years) by comparing rates of complications, restenosis, stroke, and death with those in younger patients. Methods: We retrospectively analyzed patients with symptomatic extracranial vertebral artery stenosis (VAS) treated at our center from 2019 to 2024. Patients were divided into two groups (≥70 vs. <70 years). All patients had failed medical therapy (antiplatelet ± statin) and underwent stent placement. We compared perioperative adverse events, in-stent restenosis (ISR), target-vessel stroke, and any stroke or death between groups. Results: Among 224 patients (93 aged ≥ 70, 131 aged < 70), technical success was 100%. Median age was 74 (IQR 72-77) in the ≥70 group and 63 (IQR 59-66) in the <70 group. Perioperative complication rates did not differ significantly (4.3% vs. 3.1%; Conclusion: In symptomatic patients with extracranial VAS, endovascular stenting in the elderly (≥70 years) appears comparably safe to younger patients, with similarly low restenosis and target-stroke rates. Use of bare-metal stents and hyperuricemia were associated with higher ISR. These findings support considering vertebral stenting in elderly patients, but emphasize the need for close follow-up.
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