Zhonghua Wai Ke Za Zhi. 2026 Mar 25;64:538-544. doi: 10.3760/cma.j.cn112139-20250820-00409. Online ahead of print.
ABSTRACT
Objective: To evaluate the efficacy and safety of rapamycin-eluting stents in treating stenosis of the vertebral artery V1 segment. Methods: This retrospective cohort study analyzed 191 patients with vertebral artery V1 segment stenosis who underwent stent implantation at our institution between January 2023 and August 2024. There were 161 male cases and 30 female cases. The age of the cohort was (68±8) years (range: 47 to 86 years). Patients were divided into two groups based on the stent type: the rapamycin-eluting stent (DES) group (n=93) and the bare-metal stent (BMS) group (n=98). Baseline characteristics showed no significant differences between the groups. Outcome measures included technical success rate, periprocedural (30-day) complications (stroke, mortality), and follow-up outcomes at 12 months (stent patency, stroke recurrence). Statistical analyses were performed using the independent sample t test, χ² test, or Fisher’s exact test, as appropriate. Survival analysis was conducted using the Kaplan-Meier method. Results: The operation time of patients in the DES group was (63±31) min (range: 24 to 120 min), with a technical success rate of 98.9% (92/93), and the periprocedural stroke rate within 30 d was 1.1% (1/93). The operation time of the BMS group was (58±24) min (range: 26 to 110 min), with a technical success rate of 100%, and the incidence of stroke within 30 d of the operation was 2.0% (2/98). There were no statistically significant differences in operation time, technical success rate, and the periprocedural stroke rates between the two groups (all P>0.05), and no deaths occurred in either group. A total of 91 cases in DEs group and 95 cases in BMS group were followed up for more than 12 months. The Kaplan-Meier survival analysis results showed that the patency rate at 12 months after operation, the DES group demonstrated significantly higher stent patency rates (94.5%(86/91) vs. 83.2%(79/95), χ²=5.838,P=0.016) and a higher stroke-free survival rate (97.8%(89/91) vs. 89.5%(85/95), χ²=5.410,P=0.020) compared to the BMS group. Conclusions: In the treatment of V1 segment vertebral artery stenosis, DES demonstrates a favorable perioperative safety profile, significantly higher stent patency and a lower stroke recurrence rate compared to BMS at 12 months follow-up. Further extended follow-up is required to evaluate their long-term efficacy.
PMID:41881799 | DOI:10.3760/cma.j.cn112139-20250820-00409
