Journal: Frontiers in Neurology
Article Title: Case report: Retrograde endovascular recanalization of vertebral artery occlusion with non-tapered stump via the deep cervical collateral
doi: 10.3389/fneur.2023.1246151
Figure Lengend Snippet: Endovascular procedure of the patient. (A) The micro guidewire was unable to across the occluded segment of the left vertebral artery. (B) Angiogram showed abundant collateral from the left deep cervical artery to the V3 segment of the left vertebral artery (white arrow), a tapered stump in the distal part of the occluded segment of the left vertebral artery (red arrow). (C, D) The micro guidewire reversely traversed the occluded segment of the left vertebral artery via the left deep cervical artery and was placed in the left subclavian artery [white arrow in (D) ]. (E) Balloon dilation of the left vertebral artery occlusion (white arrow). (F) Occluded left vertebral artery was successfully reopened but remained with severe stenosis (white arrow). (G) Angiogram showed severe stenosis of the V4 segment of the left vertebral artery (white arrow). (H) A balloon-expandable stent was implemented in the stenotic segment of the left vertebral artery (white arrow). (I) After stenting, the stenosis of the V4 segment has been relieved (white arrow). (J) Stent placement of the V1 segment of the left vertebral artery to prevent restenosis (white arrow).
Article Snippet: We retracted the balloon and advanced a 5F intermediate catheter (Tonbridge, Zhuhai, China) with a Transend 0.014-in micro guidewire inside (Stryker, Michigan, USA), which passed the recanalized segment and was placed in the left VA and posterior cerebral artery.
Techniques: