{"id":"3096debe-8180-43a3-ab82-08ff660e871f","slug":"key-perspectives-on-stenting-of-symptomatic-vertebral-artery-stenosis-resident-involvement-in-neurosurgery-antithrombotic-therapy-following-sellar-and-parasellar-tumor-resection-and-radiosurgery-fo","title":"Key perspectives on stenting of symptomatic vertebral artery stenosis, resident involvement in neurosurgery, antithrombotic therapy following sellar and parasellar tumor resection, and radiosurgery for vestibular schwannomas","authors":["Peter Kan","Angela Bohnen","Anand V. Germanwala","Panayiotis Pelargos","Winward Choy","Isaac Yang","Zachary A. Smith"],"abstract":"Background: The study investigates the safety and feasibility of stenting plus best medical treatment compared to best medical treatment alone in patients with symptomatic atherosclerotic vertebrobasilar artery stenosis. The presence of symptomatic vertebrobasilar atherosclerotic stenosis is associated with an increased risk of recurrent vertebrobasilar stroke. The role of stenting in this context remains inadequately defined compared to other vascular interventions. Methods: This randomized open-label phase 2 trial included patients from seven hospitals in the Netherlands between 2008 and 2013. Patients were randomized 1:1 to receive either stenting plus best medical treatment or best medical treatment alone, with outcomes assessed by a blinded endpoint committee. Primary outcomes included vascular death, myocardial infarction, and ischemic stroke within 30 days. Results: Of the 115 enrolled patients, 57 were assigned to the stenting group and 58 to the medical group. The composite outcome occurred in 5% of the stenting group compared to 2% in the medical group within 30 days. At the final follow-up, the composite outcome was similar between groups, with 19% in the stenting group and 17% in the medical group. Conclusion: Stenting plus best medical therapy appears to have a worse outcome compared to best medical therapy alone in patients with symptomatic vertebrobasilar atherosclerotic disease of at least 50%. The study highlights the need for further research to define the role of stenting in this patient population. Keywords: vertebral artery stenosis, stenting, medical treatment, symptomatic, randomized trial, outcomes","thumbnailUrl":null,"publishDate":"2016-10-07T00:00:00.000Z","doi":"10.4103/2152-7806.192514","categories":["General Neurosurgery","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/3096debe-8180-43a3-ab82-08ff660e871f/pdf"}