{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:26:32Z","timestamp":1790367992916,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The study aimed to investigate the safety, effect, and risk factors of endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery (SNOVA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Patients with SNOVA were retrospectively enrolled and treated with endovascular recanalization. The clinical data, endovascular treatment, peri-procedural complications, and follow-up outcomes were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 88 patients were enrolled, with an interval to recanalization of 2\u201389\u2009days (median 23) and an mRS of 2\u20135 (median 3 and IQR 1). Occlusion was in the intracranial vertebral artery in 68 (77.27%) patients and basilar artery in 20 (22.73%), with an occlusion length of 4.5\u201343.7\u2009mm (mean 18.3\u2009\u00b1\u20098.8). Endovascular recanalization was successful in 81 (92.0%) patients. Post-dilatation was performed in 23 (28.4%) patients. After stenting, the residual stenosis was 10%\u201340% (mean 20.2%\u2009\u00b1\u20097.6%). Peri-procedural complications occurred in 17 (19.3%) patients, with a mortality rate of 5.7%. In total, 79 (95.18%) patients underwent follow-up 5\u201329 (mean 16.9\u2009\u00b1\u20095.5) months later, with an mRS score of 0\u20136 (median 1 and IQR 1) at follow-up, being significantly (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.0001) better than that at discharge. Stroke occurred in 9 patients (11.4%) in 1\u2009year. In-stent restenosis occurred in 19 (25.33%) patients. Significant (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05) independent risk factors were blunt occlusion for successful recanalization, duration to recanalization and blunt occlusion for peri-procedural complications, and post-dilatation for both in-stent restenosis and 1-year stroke or death events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery is feasible even for a long occlusion segment, with a high recanalization rate, a low complication rate, and a good prognosis. Blunt occlusion and duration from the onset to recanalization may affect successful recanalization and peri-procedural complications while post-dilatation may affect in-stent restenosis and prognosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1125244","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T04:48:07Z","timestamp":1681447687000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery"],"prefix":"10.3389","volume":"14","author":[{"given":"ZhiLong","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TianXiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LiangFu","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LiHeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZhenKai","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YangHui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BuLang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"673367","DOI":"10.3389\/fneur.2021.673367","article-title":"Staged endovascular treatment for symptomatic occlusion originating from the intracranial vertebral arteries in the early non-acute stage","volume":"12","author":"Duan","year":"2021","journal-title":"Front Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1159\/000477626","article-title":"Multimodal therapy for non-Superacute vertebral basilar artery occlusion","volume":"6","author":"He","year":"2017","journal-title":"Interv Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"151941","DOI":"10.1016\/j.aanat.2022.151941","article-title":"Atheromatosis of the brain-supplying arteries: circle of Willis, basilar, vertebral and their branches","volume":"243","author":"Llopis","year":"2022","journal-title":"Ann Anat"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"175628642110004","DOI":"10.1177\/17562864211000453","article-title":"Endovascular intervention for basilar artery occlusion in the elderly","volume":"14","author":"Luo","year":"2021","journal-title":"Ther Adv Neurol Disord"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1177\/15910199211051830","article-title":"Percutaneous transluminal angioplasty and stenting in acute stroke caused by basilar artery steno-occlusive disease: the experience of a single stroke Centre","volume":"28","author":"Machado","year":"2022","journal-title":"Interv Neuroradiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1177\/17474930221077164","article-title":"Endovascular treatment for acute basilar artery occlusion: a multicenter randomized controlled trial (ATTENTION)","volume":"17","author":"Tao","year":"2022","journal-title":"Int J Stroke"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"598795","DOI":"10.3389\/fneur.2020.598795","article-title":"Symptomatic atherosclerotic non-acute intracranial vertebral artery Total occlusion: clinical features, imaging characteristics, endovascular recanalization, and follow-up outcomes","volume":"11","author":"Zhao","year":"2020","journal-title":"Front Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1159\/000339629","article-title":"The intracranial vertebral artery: a neglected species. 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