title: Ultrasound guided V3 segment vertebral artery direct percutaneous puncture for basilar artery mechanical thrombectomy in acute stroke: a technical report.
abstract: A middle aged patient presented with acute ischemic stroke due to basilar artery occlusion. The patient clinically deteriorated despite intravenous thrombolysis and was referred for mechanical thrombectomy. The right vertebral artery was occluded and could not be accessed despite attempting various shaped catheters, even when a radial artery access was used. The left vertebral artery ended in the posterior inferior cerebellar artery. Eventually, ultrasound guided V3 segment vertebral artery direct puncture was successfully done and the procedure was completed. No access related complications were encountered. Direct cervical arterial puncture can be safely used by experienced operators as a last resort in acute stroke cases with difficult access.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jamsheed A
authors.initials: JA
authors.lastname: Desai
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Almekhlafi
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Mayank
authors.initials: M
authors.lastname: Goyal
authors.forename: Muneer
authors.initials: M
authors.lastname: Eesa
mesh_terms: D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D061185:Mechanical Thrombolysis / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D011859:Radiography; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D018084:Ultrasonography, Interventional; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
keywords: Angiography; Stroke; Ultrasound