A Case of Successful Stent Placement for Vertebral Artery Ostium Stenosis with Favorable Outcome

Abstract Vertebral artery ostium stenosis is a recognized risk factor for posterior circulation stroke, yet no standardized treatment guidelines exist. Endovascular stenting, particularly with balloon-expandable stents (BES), has emerged as a promising option. However, clinical data remain limited. An 85-year-old man presented with transient visual disturbances and was found to have multiple microinfarcts in the right occipital lobe and cerebellar hemisphere. Vascular imaging revealed severe right VA ostium stenosis with a contralateral PICA-ending VA. In the chronic phase, the patient underwent successful stenting of the right VA ostium using a Palmaz Genesis balloon-expandable stent via radial artery access. The procedure was uneventful, and follow-up MRI showed no new infarcts. The patient was discharged with no neurological deterioration (modified Rankin scale 1). Balloon-expandable stent placement at the vertebral artery ostium can be a safe and effective treatment option in selected patients with symptomatic vertebral artery ostium stenosis. Further studies are warranted to evaluate long-term outcomes and restenosis risk.