Objectives To characterize the safety and efficacy of large woven stents in the treatment of vertebrobasilar dolichoectasia (VBD).

Methods We retrospectively reviewed 19 consecutive patients with VBD treated with large woven intracranial stent (Leo stents) between January 2016 and December 2018. The clinical symptoms and angiograms of all the patients were recorded.

Results The patients were treated with 1–3 large Leo stents (5.5 mm x 75 mm, 5.5 mm x 50 mm, or 4.5 mm x 40 mm), with or without coiling. They had follow-up angiography and MRI between 3 months and 1 year. Digital subtraction angiography showed 16 patients with complete reconstruction of the target vessels, one patient with almost complete reconstruction, and two patients with partial reconstruction. All patients had symptomatic improvement shortly after treatment, but two patients developed recurrent dysphagia at 8 and 18 months, respectively.

Conclusions Deployment of woven stents with or without supportive coiling may offer symptom relief and reconstruction in patients with VBD.