Endovascular treatment for moyamoya disease combined with symptomatic vertebrobasilar artery stenosis

TANG Xihe; LIU Yiran; WANG Dong; SHEN Junfeng; LI Qizhuang; JIAO Yonghui; LI Xiangrong; JIN Yongjian

doi:10.13798/j.issn.1009-153X.2025.09.003

Abstract：Objective To investigate the safety and efficacy of endovascular interventional therapy for Moyamoya disease combined with symptomatic vertebrobasilar artery stenosis.Methods A retrospective analysis was conducted on the clinical data of 10 patients with Moyamoya disease and symptomatic vertebrobasilar artery stenosis who underwent interven-tional treatment between March 2020 and January 2023.Results Among the cases,7 involved stenosis of the dominant ver-tebral artery,with a stenosis rate exceeding 70%;1 case had severe localized stenosis of the basilar artery,with a stenosis rate over 80%;and 2 cases exhibited severe stenosis at the junction of the vertebral and basilar arteries,with stenosis rates above 70%.All 10 patients successfully underwent endovascular interventional therapy,including vertebral artery orifice stenting in 7 cases,mid-basilar artery stenting in 1 case,and stenting at the vertebral-basilar artery junction in 2 cases.Immediate post-op-erative angiography revealed a residual stenosis rate of less than 10%.During the one-year follow-up,one patient with stenosis at the vertebral-basilar artery junction developed in-stent restenosis and underwent drug-coated balloon angioplasty as salvage therapy;one patient with vertebral artery orifice stenting developed restenosis but remained asymptomatic and continued under observation.All patients showed improvement in posterior circulation ischemia symptoms.Conclusion Endovascular inter-ventional therapy is safe and effective for patients with Moyamoya disease combined with symptomatic vertebrobasilar artery stenosis,with favorable outcomes observed at the one-year follow-up.Long-term efficacy requires continued monitoring.