title: Acute vertebral artery origin occlusion leading to basilar artery thrombosis successfully treated by angioplasty with stenting and thrombectomy.
abstract: Few reports have described the successful treatment of stroke caused by acute vertebral artery (VA) origin occlusion by endovascular surgery. We describe the case of a 68-year-old man who experienced stroke due to left acute VA origin occlusion. Cerebral angiography showed that the left VA was occluded at its origin, the right VA had hypoplastic and origin stenosis, and the basilar artery was occluded by a thrombus. The VA origin occlusion was initially passed through with a 0.035-inch guide wire. An angioplasty was performed, and a coronary stent was appropriately placed. The VA origin was successfully recanalized. A balloon-assisted guiding catheter was navigated through the stent and a thrombectomy was performed using the Penumbra system. The patient's symptoms gradually improved postoperatively. Balloon-assisted catheter guidance through a vertebral artery stent permitted a successful thrombectomy using the Penumbra system and may be useful for treating stroke due to VA origin occlusion.
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan - abe@nms.ac.jp.
authors: Arata
authors: A
authors: Abe
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Seiji
authors: S
authors: Okubo
authors: Department of Radiology, Nippon Medical School; Tokyo, Japan.
authors: Shiro
authors: S
authors: Onozawa
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Masataka
authors: M
authors: Nakajima
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Kentaro
authors: K
authors: Suzuki
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Mina
authors: M
authors: Harada-Abe
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Masayuki
authors: M
authors: Ueda
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Ken-Ichiro
authors: K
authors: Katsura
authors: Department of Internal Medicine, Division of Neurology, Nippon Medical School; Tokyo, Japan.
authors: Yasuo
authors: Y
authors: Katayama
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000295:instrumentation* / Q000379:methods; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*
keywords: stent; thrombectomy; thrombosis