NEUROINTERVENTION / CASE LIBRARY
Arterial stenosis & stent repair
Procedures, treatment principles and evidence — organized by condition.
CASE REVIEW / VERTEBRAL ARTERY
Repair of a fractured vertebral artery stent
Stent twisting, kinking and restenosis · Repeat balloon-expandable stenting
Case overview
The patient presented with episodes of visual dimming after previous stenting of the right vertebral artery origin. Worsening symptoms prompted reassessment, which demonstrated twisting, fracture, kinking and restenosis of the original stent.
Retreatment included balloon dilation, balloon-assisted passage of an intermediate catheter across the kink, catheter withdrawal and stent positioning, followed by deployment of a balloon-expandable stent. The treating physician reported satisfactory stent configuration and improved narrowing after retreatment.
Treatment principle
In this case, balloon dilation opened the narrowed segment and supported device passage; an additional stent reinforced the deformed segment. Stent-in-stent repair has been described in case reports, not established as a universal solution for every stent fracture. Case report
Shi Fei · Associate Chief PhysicianCerebrovascular Diseases · Neurointervention
Guideline context & references Expand
What the guideline says
ESVS 2023 advises against routine stenting for vertebrobasilar TIA or stroke with 50–99% vertebral stenosis. Revascularization may be considered for recurrent related symptoms despite best medical therapy with 50–99% extracranial vertebral stenosis. See recommendations 128–129. ESVS 2023 guideline
How this relates to the case
These recommendations address general treatment selection, not a dedicated repair protocol for fractured stents. This case concerns individualized retreatment of a mechanical stent problem. Visual dimming or this video alone does not establish the same indication in another patient.
Immediate improvement in stent shape and narrowing does not establish long-term patency. Medication and follow-up must be individualized by the treating clinicians.
For medical education and professional exchange, not a substitute for individualized clinical advice.
Updated