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Abstract：
BACKGROUND Vertebral artery origin stenosis (VAOS) has recently gained increased attention, with endovascular treatments like stent implantation showing high success and low complication rates, although less is known about VAOS compared to carotid artery stenosis. This study evaluated the safety and effectiveness of transradial (TRA) and transfemoral (TFA) approaches for VAOS stent placement. MATERIAL AND METHODS We recruited a total of 102 patients undergoing vertebral artery stenting in our hospital between January 2020 and November 2022. Patients were randomly assigned to undergo either radial or femoral approach for stent implantation in the vertebral artery, and the radial approach group secondary divided into 2 groups by patients\' consent: ipsilateral or contralateral radial approach. The success rates of VAOS stent implantation, operation time, and postoperative hospitalization time were compared between the 3 groups. In addition, we compared the outcomes of stroke within 30 days, transient ischemic attack (TIA) within 30 days, and other indicators. RESULTS Of the 102 patients, the final success rate of stent implantation was not significantly different between the 3 groups. The time from sheath insertion to stent insertion in the ipsilateral TRA group (median time: 19 min [interquartile range (IQR): 12-24.5 min]) was significantly shorter than in the transfemoral approach (TFA) group (median time: 29 min [IQR: 21-35.5 min]) (P<0.01; 95% confidence interval (95% CI): 10 min [6-14 min]). There were no statistically significant differences between the 3 groups in terms of cerebrovascular events within 1 month, and patient satisfaction and preference favored the radial approach. CONCLUSIONS The postoperative hospitalization time and operation time associated with the ipsilateral TRA were shorter, and patient acceptance and satisfaction were higher.
摘要：
背景技术椎动脉起源狭窄(VAOS)最近获得了越来越多的关注,血管内治疗如支架植入术显示出较高的成功率和较低的并发症发生率，尽管与颈动脉狭窄相比，对VAOS的了解较少。这项研究评估了经桡动脉（TRA）和经股动脉（TFA）方法用于VAOS支架置入的安全性和有效性。材料与方法我们招募了2020年1月至2022年11月在我院接受椎动脉支架置入术的102例患者。患者被随机分配接受桡动脉或股骨入路的椎动脉支架植入，根据患者的同意，将radial入路组其次分为2组：同侧或对侧radial入路。VAOS支架植入术的成功率,操作时间,比较3组患者术后住院时间。此外,我们比较了30天内中风的结果，短暂性脑缺血发作（TIA）30天内，其他指标。结果在102例患者中，支架植入的最终成功率在3组之间无显著差异。同侧TRA组（中位时间：19分钟[四分位距（IQR）：12-24.5分钟]）从鞘管插入到支架插入的时间明显短于经股动脉入路（TFA）组（中位时间：29分钟[IQR：21-35.5分钟]）（P<0.01；95%置信区间（95%CI）：10分钟[6-14分钟]）。3组患者1个月内脑血管事件发生率比较差异无统计学意义。患者的满意度和偏好倾向于放射状方法。结论同侧TRA患者术后住院时间和手术时间较短,患者接受度和满意度较高。
