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

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.