Endovascular therapy for acute basilar artery occlusion caused by vertebral artery dissection: Case report.

Abstract

RATIONALE:

The best endovascular therapy revascularization strategies for acute ischemic stroke caused by vertebral artery dissection (VAD) are unclear. We describes a case of basilar artery (BA) occlusion caused by extracranial VAD, in which we used a stent-retriever to achieve thrombectomy in the BA through the contralateral vertebral artery (VA).

PATIENT CONCERNS:

A 32-year-old male presented with a sudden-onset headache accompanied by articulation disorder, left-sided weakness, and tinnitus in the left ear.

DIAGNOSIS:

Digital subtraction angiography showed the V1 to V2 segment dissection of the left VA and occlusion of the BA.

INTERVENTIONS:

Thrombectomy was performed through the thinner right VA with three passes of the Solitaire FR device 4 × 20 mm in the BA, and angiograms showed modified treatment in cerebral ischemia 3 reperfusion of BA and left VA V4 segment still occluded.

OUTCOMES:

The patient had a modified Rankin Scale of 2 at 90 days, and re-established blood flow of the left VA and BA.

LESSONS:

When extracranial VAD complicated with BA occlusion, choosing the clean-road path to perform a BA thrombectomy may be a fast and effective treatment strategy.

• Authors: Changchun Jiang, Jiahui Liu, Jinfeng Zhang, Yujuan Cui, Junfeng Yang, Fei Hao, Yu Fan, Jianqi Wei
• Journal: Medicine (Medicine (Baltimore)) Vol. 100 Issue 47 Pg. e27995 (Nov 24 2021) ISSN: 1536-5964 [Electronic] United States
• PMID: 34964795 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Topics

• Adult
• Angiography
• Arterial Occlusive Diseases (etiology, surgery)
• Basilar Artery (diagnostic imaging, surgery)
• Brain Ischemia
• Endovascular Procedures (methods)
• Humans
• Male
• Stents
• Stroke
• Thrombectomy (methods)
• Vertebral Artery Dissection (complications, surgery)