Takikawa Kohei, Doijiri Ryosuke, Ohyama Ayane, Sonoda Takuji, Yamazaki Naoya, Sato Mitsunobu, Yokosawa Michiko, Takahashi Ken, Sugawara Takayuki, Kimura Naoto
Department of Neurology, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
J Neuroendovasc Ther. 2022;16(6):327-334. doi: 10.5797/jnet.cr.2021-0050. Epub 2021 Oct 1.
There are few reports on endovascular treatment of tandem lesions in the posterior circulation and no consensus on treatment strategies has been reached. We report a case of tandem lesions of basilar artery occlusion and vertebral artery stenosis treated by thrombectomy and vertebral artery stenting.
We present the case of a 73-year-old man who developed consciousness disorder and tetraplegia. Head and neck CTA revealed tandem left vertebral artery stenosis and basilar artery occlusion. The patient was treated using a reverse technique, which involves performing thrombectomy first and then vertebral artery stenting, along with Carotid Guardwire PS. Postoperative impairment of consciousness and improvement of tetraplegia were achieved.
The reverse technique combined with Carotid Guardwire PS may be a useful treatment strategy for tandem lesions in the posterior circulation.
关于后循环串联病变的血管内治疗报道较少，且尚未就治疗策略达成共识。我们报告1例基底动脉闭塞合并椎动脉狭窄的串联病变患者，经血栓切除术和椎动脉支架置入术治疗。
我们报告1例73岁男性患者，出现意识障碍和四肢瘫痪。头颈部CTA显示左侧椎动脉串联狭窄和基底动脉闭塞。该患者采用逆向技术治疗，即先进行血栓切除术，然后进行椎动脉支架置入术，并使用颈动脉保护导丝PS。术后意识障碍有所改善，四肢瘫痪情况好转。
逆向技术联合颈动脉保护导丝PS可能是治疗后循环串联病变的有效策略。
