{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:30:49Z","timestamp":1767349849535,"version":"3.48.0"},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Vertebral artery ostium (VAO) stenosis treatment with balloon-expandable stents is challenging due to precise positioning difficulties and high rates of restenosis and fracture. Self-expanding stents (SES) using the crossover technique from VAO to proximal subclavian artery may offer better accessibility, though long-term outcomes remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Ten patients with symptomatic VAO stenosis underwent SES placement using the crossover technique, extending from V1 segment to proximal subclavian artery. Tortuosity index was measured from digital subtraction angiography frontal projections using automated analysis with manual correction at pre-procedure, post-procedure, and >3-year follow-up. Clinical and angiographic outcomes were evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Technical success was 100%. Mean tortuosity index improved from 1.15 \u00b1 0.09 to 1.03 \u00b1 0.03 post-procedure (\n P<\/jats:italic>\n < 0.01) and remained stable at 1.02 \u00b1 0.02 at mean 4.1-year follow-up. No restenosis occurred. One fracture (10%) occurred at an intentionally balloon-dilated site for future radial access; no unintended mechanical failures occurred (0\/9).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n SES crossover technique demonstrates excellent long-term structural integrity with stable vessel geometry and zero unintended fractures over >3 years in VAO treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_960_2025","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T07:32:24Z","timestamp":1765524744000},"page":"523","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term biomechanical stability of self-expanding stents using the crossover technique for vertebral artery ostium stenosis: A tortuosity index analysis"],"prefix":"10.25259","volume":"16","author":[{"given":"Syunsuke","family":"Taniguchi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Harada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahito","family":"Kajihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"10.25259\/SNI_960_2025\/ref-1","doi-asserted-by":"crossref","first-page":"156","DOI":"10.3348\/kjr.2010.11.2.156","article-title":"Use of self-expanding stents for the treatment of vertebral artery ostial stenosis: A single center experience","volume":"11","author":"Chung","year":"2010","journal-title":"Korean J Radiol"},{"key":"10.25259\/SNI_960_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.jvs.2010.02.009","article-title":"Carotid artery stent fracture identification and clinical relevance","volume":"51","author":"Coppi","year":"2010","journal-title":"J Vasc Surg"},{"key":"10.25259\/SNI_960_2025\/ref-3","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.jelekin.2012.03.005","article-title":"Vertebral artery strains during high-speed, low amplitude cervical spinal manipulation","volume":"22","author":"Herzog","year":"2012","journal-title":"J Electromyogr Kinesiol"},{"key":"10.25259\/SNI_960_2025\/ref-4","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jvs.2008.10.019","article-title":"Prevalence, factors, and clinical impact of self-expanding stent fractures following iliac artery stenting","volume":"49","author":"Higashiura","year":"2009","journal-title":"J Vasc Surg"},{"key":"10.25259\/SNI_960_2025\/ref-5","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jacc.2009.08.069","article-title":"Endovascular stenting for vertebral artery stenosis","volume":"55","author":"Jenkins","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"10.25259\/SNI_960_2025\/ref-6","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1177\/1591019920935276","article-title":"Endovascular treatment of the vertebral artery origin stenosis by using the closed-cell, self-expandable Carotid Wallstent","volume":"26","author":"Ko","year":"2020","journal-title":"Interv Neuroradiol"},{"key":"10.25259\/SNI_960_2025\/ref-7","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jocn.2013.04.022","article-title":"Stenting of symptomatic vertebral artery ostium stenosis with self-expanding stents","volume":"21","author":"Li","year":"2014","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_960_2025\/ref-8","doi-asserted-by":"crossref","first-page":"755","DOI":"10.15274\/INR-2014-10068","article-title":"Stent fracture and occlusion after treatment of symptomatic vertebral artery ostium stenosis with a self-expanding device. A case report","volume":"20","author":"Lu","year":"2014","journal-title":"Interv Neuroradiol"},{"key":"10.25259\/SNI_960_2025\/ref-9","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.jacc.2004.11.026","article-title":"Prevalence and clinical impact of stent fractures after femoropopliteal stenting","volume":"45","author":"Scheinert","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"10.25259\/SNI_960_2025\/ref-10","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1161\/STROKEAHA.110.611459","article-title":"A systematic review of stenting and angioplasty of symptomatic extracranial vertebral artery stenosis","volume":"42","author":"Stayman","year":"2011","journal-title":"Stroke"},{"key":"10.25259\/SNI_960_2025\/ref-11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/1526602816676254","article-title":"Dynamic respiratory tortuosity of the vertebral artery ostium","volume":"24","author":"Tang","year":"2017","journal-title":"J Endovasc Ther"},{"key":"10.25259\/SNI_960_2025\/ref-12","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00234-006-0185-x","article-title":"Stent fracture in revascularization for symptomatic ostial vertebral artery stenosis","volume":"49","author":"Tsutsumi","year":"2007","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_960_2025\/ref-13","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1583\/09-2904.1","article-title":"Drug-eluting stents for the treatment of vertebral artery origin stenosis","volume":"17","author":"Werner","year":"2010","journal-title":"J Endovasc Ther"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/long-term-biomechanical-stability-of-self-expanding-stents-using-the-crossover-technique-for-vertebral-artery-ostium-stenosis-a-tortuosity-index-analysis\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/long-term-biomechanical-stability-of-self-expanding-stents-using-the-crossover-technique-for-vertebral-artery-ostium-stenosis-a-tortuosity-index-analysis\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:28:03Z","timestamp":1767349683000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/long-term-biomechanical-stability-of-self-expanding-stents-using-the-crossover-technique-for-vertebral-artery-ostium-stenosis-a-tortuosity-index-analysis\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":13,"alternative-id":["10.25259\/SNI_960_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_960_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"type":"electronic","value":"2152-7806"},{"type":"print","value":"2229-5097"}],"subject":[],"published":{"date-parts":[[2025,12,12]]},"article-number":"523"}}