{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:04:09Z","timestamp":1791475449724,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T00:00:00Z","timestamp":1478736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:p>Purpose: To determine the prevalence of dynamic respiratory tortuosity (DRT) of the vertebral artery ostium (VAO) as well as to evaluate its correlation with in-stent restenosis (ISR) and stent fracture. Methods: From March 2012 to June 2015, 178 consecutive patients (mean age 65.2\u00b15.8 years; 124 men) with symptoms of atherosclerotic vertebrobasilar ischemia underwent angiography prior to stent implantation in the vertebral, subclavian, and\/or carotid arteries. In this cohort, 54 patients (mean age 67.3\u00b15.3 years; 40 men) had VAO stent implantation. Angiography of the vertebral artery was recorded in 2 phases with breath-hold: deep inspiration (DIP) and deep expiration (DEP). Obvious VAO tortuosity was defined as any VAO angle \u2264120\u00b0 in DIP. Obvious VAO-DRT was defined as any VAO angle increasing \u226560\u00b0 from DIP to DEP. Computed tomography angiography (CTA) or digital subtraction angiography was used in follow-up to detect ISR and stent fracture. Results: Of the 178 patients in this study, 21 (11.8%) had obvious VAO tortuosity and 8 (4.5%) had obvious VAO-DRT. Two of the 21 patients with obvious VAO tortuosity also had obvious VAO-DRT. Three of the 54 VAO stent patients had VAO-DRT. There were no correlations between VAO-DRT and age, sex, risk factors, body mass index, chronic obstructive pulmonary disease, asthma, or obvious VAO tortuosity (p&gt;0.05). Over a mean follow-up of 28\u00b110 months, there were 4 (7.4%) asymptomatic VAO ISR cases. Two (3.7%) were occlusions at 6 and 12 months, respectively; both were associated with stent fracture in patients with obvious VAO-DRT before stenting. Both stents fractured at the tortuous VAO region. VAO-DRT was correlated with stent fracture (Spearman \u03c1=0.81, p&lt;0.01) and ISR (Spearman \u03c1=0.55, p&lt;0.01). Conclusion: VAO-DRT could be a risk factor for stent fracture and restenosis after VAO stent implantation. Angiography in both inspiration and expiration phases, especially the latter, should be considered before VAO stenting. Using a shorter stent to avoid crossing the tortuosity could reduce the occurrence of fracture.<\/jats:p>","DOI":"10.1177\/1526602816676254","type":"journal-article","created":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T07:23:07Z","timestamp":1478762587000},"page":"124-129","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Dynamic Respiratory Tortuosity of the Vertebral Artery Ostium"],"prefix":"10.1177","volume":"24","author":[{"given":"Xiaobin","family":"Tang","sequence":"first","affiliation":[{"name":"Vascular Surgery Department, Beijing Anzhen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Tang","sequence":"additional","affiliation":[{"name":"Vascular Department, First Hospital of Tsinghua University, Beijing, 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