Case report and literature review of stent detachment after vertebral artery stenting

This study presents a case of severe stenosis at the origin of the left vertebral artery, which was complicated by stent detachment after stent implantation. We carried out a retrospective analysis of the patient's clinical data and undertook a review of relevant literature. Our goals were to investigate potential risk factors for stent detachment, assess how well conservative management works in such scenarios, and offer evidence to guide individualized treatment for this type of complication. The patient was a 70-year-old male who received a self-expanding Enterprise 2 stent at the origin of his left vertebral artery. At the 2-month follow-up, imaging showed stent migration and detachment into the left subclavian artery. Importantly, there was no evidence of significant vascular occlusion or acute neurological deficits. We managed the patient conservatively with dual antiplatelet and lipid-lowering therapy. After this treatment, his clinical condition improved, vital signs stayed stable, and neurological function was preserved. Our combined analysis of this case and the existing literature indicates that systemic vascular degeneration and the unique anatomical features of the vertebral artery's V1 segment are key contributors to stent detachment. In our experience, conservative treatment can lead to good outcomes for patients who are hemodynamically stable and have no ischemic symptoms. Clinical care should be tailored to each patient to avoid unnecessary repeat interventions.