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<meta name="citation_funding_source" content="citation_grant_number=2020R1A2C2100077;" />
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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Prognosis of Proximal and Distal Vertebrobasilar Artery Stent Placement" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8389" />
<meta name="DC.Date" content="2024-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Vertebrobasilar artery stent placement (VBS) is potentially effective in preventing recurrent posterior circulation strokes; however, the incidences of in-stent restenosis and stented-territory ischemic events based on the location of stent placement have rarely been investigated. We aimed to investigate the characteristics and prognosis of VBS between intracranial and extracranial.

MATERIALS AND METHODS: This study was single-center retrospective cohort study, and we obtained medical records of patients who underwent VBS. We compared clinical and periprocedural factors between extracranial and intracranial VBS. The primary outcomes included the incidence of in-stent restenosis (&gt;50% reduction in lumen diameter) and stented-territory ischemic events. We compared the incidence of in-stent restenosis and stented-territory ischemic events by using Kaplan-Meier curves.

RESULTS: Of the 105 patients, 41 (39.0%) underwent extracranial VBS, and 64 (61.0%) underwent intracranial VBS. During the follow-up, the incidences of in-stent restenosis and stented-territory ischemic events were 15.2% and 22.9%, respectively. The procedure time was longer (47.7 ± 19.5 minutes versus 74.5 ± 35.2 minutes, P &lt; .001), and the rate of residual stenosis (≥30%) just after VBS was higher (2 [4.9%] versus 24 [37.5%], P &lt; .001) in intracranial VBS than in extracranial VBS. Also, the incidences of in-stent restenosis were significantly higher in intracranial VBS than in extracranial VBS (4.9% versus 21.9%, P = .037). On the other hand, the incidences of stented-territory ischemic events (7.3% versus 32.8%, P &lt; .001) were significantly higher in intracranial VBS than in extracranial VBS. The main mechanisms of stroke were artery-to-artery embolism (2 [66.7%]) in extracranial VBS, and artery-to-artery embolism (9 [42.9%]) and branch atheromatous disease (8 [38.1%]) in intracranial VBS. The Kaplan-Meier curve demonstrated a higher incidence of in-stent restenosis and stented-territory ischemic events in intracranial VBS than in extracranial VBS ( P = .008 and P = .002, respectively).

CONCLUSIONS: During the follow-up, the incidence of in-stent restenosis and stented-territory ischemic events was higher in patients with intracranial VBS than in those with extracranial VBS. The higher rates of postprocedural residual stenosis might have contributed to the increased risk of in-stent restenosis. Furthermore, prolonged procedure time and additional stroke mechanism, including branch atheromatous disease, might be associated with a higher risk of stented-territory ischemic events in intracranial VBS.

ARU
:   aspirin reaction unit
EPD
:   embolic protection device
HbA1c
:   hemoglobin A1c
PRU
:   P2Y12 reaction units
VBS
:   vertebrobasilar artery stent placement" />
<meta name="DC.Contributor" content="Jae-Chan Ryu" />
<meta name="DC.Contributor" content="Sang-Hun Lee" />
<meta name="DC.Contributor" content="Jun Sang Yoo" />
<meta name="DC.Contributor" content="Boseong Kwon" />
<meta name="DC.Contributor" content="Yunsun Song" />
<meta name="DC.Contributor" content="Deok Hee Lee" />
<meta name="DC.Contributor" content="Jae-Han Bae" />
<meta name="DC.Contributor" content="Jun Young Chang" />
<meta name="DC.Contributor" content="Dong-Wha Kang" />
<meta name="DC.Contributor" content="Sun U. Kwon" />
<meta name="DC.Contributor" content="Jong S. Kim" />
<meta name="DC.Contributor" content="Bum Joon Kim" />
<meta name="article:published_time" content="2024-11-01" />
<meta name="article:section" content="Neurointervention" />
<meta name="citation_title" content="Prognosis of Proximal and Distal Vertebrobasilar Artery Stent Placement" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Vertebrobasilar artery stent placement (VBS) is potentially effective in preventing recurrent posterior circulation strokes; however, the incidences of in-stent restenosis and stented-territory ischemic events based on the location of stent placement have rarely been investigated. We aimed to investigate the characteristics and prognosis of VBS between intracranial and extracranial.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;This study was single-center retrospective cohort study, and we obtained medical records of patients who underwent VBS. We compared clinical and periprocedural factors between extracranial and intracranial VBS. The primary outcomes included the incidence of in-stent restenosis (&amp;gt;50% reduction in lumen diameter) and stented-territory ischemic events. We compared the incidence of in-stent restenosis and stented-territory ischemic events by using Kaplan-Meier curves.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of the 105 patients, 41 (39.0%) underwent extracranial VBS, and 64 (61.0%) underwent intracranial VBS. During the follow-up, the incidences of in-stent restenosis and stented-territory ischemic events were 15.2% and 22.9%, respectively. The procedure time was longer (47.7 ± 19.5 minutes versus 74.5 ± 35.2 minutes, &lt;i&gt;P&lt;/i&gt; &amp;lt; .001), and the rate of residual stenosis (≥30%) just after VBS was higher (2 [4.9%] versus 24 [37.5%], &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) in intracranial VBS than in extracranial VBS. Also, the incidences of in-stent restenosis were significantly higher in intracranial VBS than in extracranial VBS (4.9% versus 21.9%, &lt;i&gt;P&lt;/i&gt; = .037). On the other hand, the incidences of stented-territory ischemic events (7.3% versus 32.8%, &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) were significantly higher in intracranial VBS than in extracranial VBS. The main mechanisms of stroke were artery-to-artery embolism (2 [66.7%]) in extracranial VBS, and artery-to-artery embolism (9 [42.9%]) and branch atheromatous disease (8 [38.1%]) in intracranial VBS. The Kaplan-Meier curve demonstrated a higher incidence of in-stent restenosis and stented-territory ischemic events in intracranial VBS than in extracranial VBS (&lt;i&gt;P&lt;/i&gt; = .008 and &lt;i&gt;P&lt;/i&gt; = .002, respectively).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;During the follow-up, the incidence of in-stent restenosis and stented-territory ischemic events was higher in patients with intracranial VBS than in those with extracranial VBS. The higher rates of postprocedural residual stenosis might have contributed to the increased risk of in-stent restenosis. Furthermore, prolonged procedure time and additional stroke mechanism, including branch atheromatous disease, might be associated with a higher risk of stented-territory ischemic events in intracranial VBS.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2024/11/01" />
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<meta name="citation_section" content="Neurointervention" />
<meta name="citation_firstpage" content="1685" />
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<meta name="citation_author" content="Jae-Chan Ryu" />
<meta name="citation_author_institution" content="aFrom the Department of Neurology (J.-C.R., S.-H.L.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea" />
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<meta name="citation_author" content="Sang-Hun Lee" />
<meta name="citation_author_institution" content="aFrom the Department of Neurology (J.-C.R., S.-H.L.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-9538-446X" />
<meta name="citation_author" content="Jun Sang Yoo" />
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<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-2033-1002" />
<meta name="citation_author" content="Boseong Kwon" />
<meta name="citation_author_institution" content="bDepartment of Radiology (J.S.Y., B.K., Y.S., D.H.L.), University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6113-9730" />
<meta name="citation_author" content="Yunsun Song" />
<meta name="citation_author_institution" content="bDepartment of Radiology (J.S.Y., B.K., Y.S., D.H.L.), University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-4738-0533" />
<meta name="citation_author" content="Deok Hee Lee" />
<meta name="citation_author_institution" content="bDepartment of Radiology (J.S.Y., B.K., Y.S., D.H.L.), University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-0355-0449" />
<meta name="citation_author" content="Jae-Han Bae" />
<meta name="citation_author_institution" content="cDepartment of Neurology (J.-H.B., J.Y.C., D.-W.K., S.U.K., B.J.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-1538-6642" />
<meta name="citation_author" content="Jun Young Chang" />
<meta name="citation_author_institution" content="cDepartment of Neurology (J.-H.B., J.Y.C., D.-W.K., S.U.K., B.J.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-4880-9258" />
<meta name="citation_author" content="Dong-Wha Kang" />
<meta name="citation_author_institution" content="cDepartment of Neurology (J.-H.B., J.Y.C., D.-W.K., S.U.K., B.J.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-2999-485X" />
<meta name="citation_author" content="Sun U. Kwon" />
<meta name="citation_author_institution" content="cDepartment of Neurology (J.-H.B., J.Y.C., D.-W.K., S.U.K., B.J.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-8302-331X" />
<meta name="citation_author" content="Jong S. Kim" />
<meta name="citation_author_institution" content="dDepartment of Neurology (J.S.K.), Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-3278-3252" />
<meta name="citation_author" content="Bum Joon Kim" />
<meta name="citation_author_institution" content="cDepartment of Neurology (J.-H.B., J.Y.C., D.-W.K., S.U.K., B.J.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea" />
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<meta name="twitter:title" content="Prognosis of Proximal and Distal Vertebrobasilar Artery Stent Placement" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/11.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Vertebrobasilar artery stent placement (VBS) is potentially effective in preventing recurrent posterior circulation strokes; however, the incidences of in-stent restenosis and stented-territory ischemic events based on the location of stent placement have rarely been investigated. We aimed to investigate the characteristics and prognosis of VBS between intracranial and extracranial.

MATERIALS AND METHODS: This study was single-center retrospective cohort study, and we obtained medical records of patients who underwent VBS. We compared clinical and periprocedural factors between extracranial and intracranial VBS. The primary outcomes included the incidence of in-stent restenosis (&gt;50% reduction in lumen diameter) and stented-territory ischemic events. We compared the incidence of in-stent restenosis and stented-territory ischemic events by using Kaplan-Meier curves.

RESULTS: Of the 105 patients, 41 (39.0%) underwent extracranial VBS, and 64 (61.0%) underwent intracranial VBS. During the follow-up, the incidences of in-stent restenosis and stented-territory ischemic events were 15.2% and 22.9%, respectively. The procedure time was longer (47.7 ± 19.5 minutes versus 74.5 ± 35.2 minutes, P &lt; .001), and the rate of residual stenosis (≥30%) just after VBS was higher (2 [4.9%] versus 24 [37.5%], P &lt; .001) in intracranial VBS than in extracranial VBS. Also, the incidences of in-stent restenosis were significantly higher in intracranial VBS than in extracranial VBS (4.9% versus 21.9%, P = .037). On the other hand, the incidences of stented-territory ischemic events (7.3% versus 32.8%, P &lt; .001) were significantly higher in intracranial VBS than in extracranial VBS. The main mechanisms of stroke were artery-to-artery embolism (2 [66.7%]) in extracranial VBS, and artery-to-artery embolism (9 [42.9%]) and branch atheromatous disease (8 [38.1%]) in intracranial VBS. The Kaplan-Meier curve demonstrated a higher incidence of in-stent restenosis and stented-territory ischemic events in intracranial VBS than in extracranial VBS ( P = .008 and P = .002, respectively).

CONCLUSIONS: During the follow-up, the incidence of in-stent restenosis and stented-territory ischemic events was higher in patients with intracranial VBS than in those with extracranial VBS. The higher rates of postprocedural residual stenosis might have contributed to the increased risk of in-stent restenosis. Furthermore, prolonged procedure time and additional stroke mechanism, including branch atheromatous disease, might be associated with a higher risk of stented-territory ischemic events in intracranial VBS.

ARU
:   aspirin reaction unit
EPD
:   embolic protection device
HbA1c
:   hemoglobin A1c
PRU
:   P2Y12 reaction units
VBS
:   vertebrobasilar artery stent placement" />
<meta name="og-title" property="og:title" content="Prognosis of Proximal and Distal Vertebrobasilar Artery Stent Placement" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/11/1685" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Vertebrobasilar artery stent placement (VBS) is potentially effective in preventing recurrent posterior circulation strokes; however, the incidences of in-stent restenosis and stented-territory ischemic events based on the location of stent placement have rarely been investigated. We aimed to investigate the characteristics and prognosis of VBS between intracranial and extracranial.

MATERIALS AND METHODS: This study was single-center retrospective cohort study, and we obtained medical records of patients who underwent VBS. We compared clinical and periprocedural factors between extracranial and intracranial VBS. The primary outcomes included the incidence of in-stent restenosis (&gt;50% reduction in lumen diameter) and stented-territory ischemic events. We compared the incidence of in-stent restenosis and stented-territory ischemic events by using Kaplan-Meier curves.

RESULTS: Of the 105 patients, 41 (39.0%) underwent extracranial VBS, and 64 (61.0%) underwent intracranial VBS. During the follow-up, the incidences of in-stent restenosis and stented-territory ischemic events were 15.2% and 22.9%, respectively. The procedure time was longer (47.7 ± 19.5 minutes versus 74.5 ± 35.2 minutes, P &lt; .001), and the rate of residual stenosis (≥30%) just after VBS was higher (2 [4.9%] versus 24 [37.5%], P &lt; .001) in intracranial VBS than in extracranial VBS. Also, the incidences of in-stent restenosis were significantly higher in intracranial VBS than in extracranial VBS (4.9% versus 21.9%, P = .037). On the other hand, the incidences of stented-territory ischemic events (7.3% versus 32.8%, P &lt; .001) were significantly higher in intracranial VBS than in extracranial VBS. The main mechanisms of stroke were artery-to-artery embolism (2 [66.7%]) in extracranial VBS, and artery-to-artery embolism (9 [42.9%]) and branch atheromatous disease (8 [38.1%]) in intracranial VBS. The Kaplan-Meier curve demonstrated a higher incidence of in-stent restenosis and stented-territory ischemic events in intracranial VBS than in extracranial VBS ( P = .008 and P = .002, respectively).

CONCLUSIONS: During the follow-up, the incidence of in-stent restenosis and stented-territory ischemic events was higher in patients with intracranial VBS than in those with extracranial VBS. The higher rates of postprocedural residual stenosis might have contributed to the increased risk of in-stent restenosis. Furthermore, prolonged procedure time and additional stroke mechanism, including branch atheromatous disease, might be associated with a higher risk of stented-territory ischemic events in intracranial VBS.

ARU
:   aspirin reaction unit
EPD
:   embolic protection device
HbA1c
:   hemoglobin A1c
PRU
:   P2Y12 reaction units
VBS
:   vertebrobasilar artery stent placement" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node111450--5" data-node-nid="111450" id="top-node-111450--610040964" data-pisa="ajnr;45/11/1685" data-pisa-master="ajnr;ajnr.A8389" data-apath="/ajnr/45/11/1685.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Neurointervention</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Prognosis of Proximal and Distal Vertebrobasilar Artery Stent Placement</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Jae-Chan Ryu</span>, <span class="highwire-citation-author" data-delta="1">Sang-Hun Lee</span>, <span class="highwire-citation-author" data-delta="2">Jun Sang Yoo</span>, <span class="highwire-citation-author" data-delta="3">Boseong Kwon</span>, <span class="highwire-citation-author" data-delta="4">Yunsun Song</span>, <span class="highwire-citation-author" data-delta="5">Deok Hee Lee</span>, <span class="highwire-citation-author" data-delta="6">Jae-Han Bae</span>, <span class="highwire-citation-author" data-delta="7">Jun Young Chang</span>, <span class="highwire-citation-author" data-delta="8">Dong-Wha Kang</span>, <span class="highwire-citation-author" data-delta="9">Sun U. Kwon</span>, <span class="highwire-citation-author" data-delta="10">Jong S. Kim</span> and <span class="highwire-citation-author" data-delta="11">Bum Joon Kim</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1685-1691; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8389 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-111450--610040964" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Jae-Chan Ryu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology (J.-C.R., S.-H.L.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jae-Chan%2BRyu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ryu%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li 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Ulsan College of Medicine, Seoul, South Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jun%2BSang%2BYoo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yoo%20JS&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJun%2BSang%2BYoo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2033-1002" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Jun Sang 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class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Dong-Wha%2BKang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kang%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ADong-Wha%2BKang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2999-485X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Dong-Wha Kang</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">Sun U. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Vertebrobasilar artery stent placement (VBS) is potentially effective in preventing recurrent posterior circulation strokes; however, the incidences of in-stent restenosis and stented-territory ischemic events based on the location of stent placement have rarely been investigated. We aimed to investigate the characteristics and prognosis of VBS between intracranial and extracranial.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> This study was single-center retrospective cohort study, and we obtained medical records of patients who underwent VBS. We compared clinical and periprocedural factors between extracranial and intracranial VBS. The primary outcomes included the incidence of in-stent restenosis (&gt;50% reduction in lumen diameter) and stented-territory ischemic events. We compared the incidence of in-stent restenosis and stented-territory ischemic events by using Kaplan-Meier curves.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> Of the 105 patients, 41 (39.0%) underwent extracranial VBS, and 64 (61.0%) underwent intracranial VBS. During the follow-up, the incidences of in-stent restenosis and stented-territory ischemic events were 15.2% and 22.9%, respectively. The procedure time was longer (47.7 ± 19.5 minutes versus 74.5 ± 35.2 minutes, <em>P</em> &lt; .001), and the rate of residual stenosis (≥30%) just after VBS was higher (2 [4.9%] versus 24 [37.5%], <em>P</em> &lt; .001) in intracranial VBS than in extracranial VBS. Also, the incidences of in-stent restenosis were significantly higher in intracranial VBS than in extracranial VBS (4.9% versus 21.9%, <em>P</em> = .037). On the other hand, the incidences of stented-territory ischemic events (7.3% versus 32.8%, <em>P</em> &lt; .001) were significantly higher in intracranial VBS than in extracranial VBS. The main mechanisms of stroke were artery-to-artery embolism (2 [66.7%]) in extracranial VBS, and artery-to-artery embolism (9 [42.9%]) and branch atheromatous disease (8 [38.1%]) in intracranial VBS. The Kaplan-Meier curve demonstrated a higher incidence of in-stent restenosis and stented-territory ischemic events in intracranial VBS than in extracranial VBS (<em>P</em> = .008 and <em>P</em> = .002, respectively).</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> During the follow-up, the incidence of in-stent restenosis and stented-territory ischemic events was higher in patients with intracranial VBS than in those with extracranial VBS. The higher rates of postprocedural residual stenosis might have contributed to the increased risk of in-stent restenosis. Furthermore, prolonged procedure time and additional stroke mechanism, including branch atheromatous disease, might be associated with a higher risk of stented-territory ischemic events in intracranial VBS.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">ARU<span class="def-item-dt-sep"></span></dt><dd>aspirin reaction unit<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">EPD<span class="def-item-dt-sep"></span></dt><dd>embolic protection device<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">HbA<sub>1c</sub><span class="def-item-dt-sep"></span></dt><dd>hemoglobin A<sub>1c</sub><span class="def-item-dd-sep"></span></dd><dt id="def-item-4">PRU<span class="def-item-dt-sep"></span></dt><dd>P2Y12 reaction units<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">VBS<span class="def-item-dt-sep"></span></dt><dd>vertebrobasilar artery stent placement</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2024 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/45/11/1685.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2024 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Jae-Chan</span> <span class="nlm-surname">Ryu</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Sang-Hun</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Jun Sang</span> <span class="nlm-surname">Yoo</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Boseong</span> <span class="nlm-surname">Kwon</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Yunsun</span> <span class="nlm-surname">Song</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Deok Hee</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Jae-Han</span> <span class="nlm-surname">Bae</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Jun Young</span> <span class="nlm-surname">Chang</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Dong-Wha</span> <span class="nlm-surname">Kang</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Sun U.</span> <span class="nlm-surname">Kwon</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Jong S.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Bum Joon</span> <span class="nlm-surname">Kim</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1685-1691; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8389 </span></div>
  
  
  
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      <div class="highwire-cite-title">Prognosis of Vertebrobasilar Artery Stenting</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Jae-Chan</span> <span class="nlm-surname">Ryu</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Sang-Hun</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Jun Sang</span> <span class="nlm-surname">Yoo</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Boseong</span> <span class="nlm-surname">Kwon</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Yunsun</span> <span class="nlm-surname">Song</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Deok Hee</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Jae-Han</span> <span class="nlm-surname">Bae</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Jun Young</span> <span class="nlm-surname">Chang</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Dong-Wha</span> <span class="nlm-surname">Kang</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Sun U.</span> <span class="nlm-surname">Kwon</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Jong S.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Bum Joon</span> <span class="nlm-surname">Kim</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1685-1691; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8389 </span></div>
  
  
  
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