Vertebral Artery Origin Treatment Via Endovascular Techniques Registry (VOTER)

A retrospective registry of stenting plus medical management for the prevention of recurrent stroke in patients with symptomatic Vertebral Artery origin Stenosis (VAOS). This study is collecting information on clinical outcomes up to 18 months post-treatment.

On January 6, 2025, VOTER was changed from prospective to retrospective.

• Observational Prospective Registry (Other), also known as Observational: This is a prospective registry looking at patients admitted for stroke with evidence of Vertebral Artery Origin Stenosis. Patients clinical outcomes will be collected at 30 days and 1-year post-treatment and angiographic outcomes at 1-year post-treatment

Primary outcomes

• Incidence of recurrent stroke or death [1 Year post-treatment]: Recurrent stroke of any type or death from any cause

Secondary outcomes

• Incidence of Restenosis [1 Year post-treatment]: Restenosis in VAOS patients treated with drug-eluting stents.

Sex: All, ages: 18 Years to 90 Years

Inclusion Criteria:

1. Patients between 18 and 90 years of age
2. Patient has experienced a posterior circulation ischemic event
3. Patient has angiographically confirmed bilateral vertebral artery origin disease (Hypoplasia, occlusion, or stenosis).
4. Patient has >50% stenosis on the side being targeted for therapy

Exclusion Criteria:

1. Pregnant women
2. Contrast Indication to the use of anti-platelet drugs
3. There is tandem vertebral or basilar artery stenosis
4. The serum creatinin is >2.5
5. Baseline modified Rankin score is >3
6. < 5 years life expectancy

• Randall Edgell, MD, Principal investigator, St. Louis University