title: Thrombectomy using a stent retriever with artificially induced vertebral artery vasospasm in a patient with acute basilar artery occlusion: a case report.
abstract: An acute basilar artery occlusion is not an uncommon cause of stroke. It represents 6-10% of large vessel strokes and has been associated with poor clinical outcomes. Multimodal treatments have been introduced to recanalise a basilar artery occlusion successfully. However, all mechanical thrombectomy devices are not always usable in an emergent situation. We present a case of basilar artery occlusion treated with a stent retriever assisted by a vertebral artery vasospasm. We attempted thrombectomy with a stent retriever several times. However, the captured thrombus was not pulled out and migrated to the distal basilar artery and posterior cerebral artery due to anterograde flow of the vertebral artery. We carefully advanced the catheter into the distal vertebral artery and generated a vasospasm. The vertebral artery vasospasm reduced the forward flow significantly like a balloon-guided catheter. The thrombus was pulled out with the stent.
authors.affiliation: Department of Radiology, Busan-Ulsan Regional Cardio-Cerebrovascular Diseases Center, Republic of Korea.
authors.forename: Sanghyeon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Radiology, Busan-Ulsan Regional Cardio-Cerebrovascular Diseases Center, Republic of Korea myongjinkang1@gmail.com.
authors.forename: Myongjin
authors.initials: M
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, Busan-Ulsan Regional Cardio-Cerebrovascular Diseases Center, Republic of Korea.
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Choi
mesh_terms: D000368:Aged; D020878:Device Removal / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation*; D015641:Radiography, Interventional / Q000379:methods; D015607:Stents; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: Basilar artery occlusion; thrombectomy; vasospasm