Endovascular therapy for acute basilar artery occlusion caused by vertebral artery dissection Case report

Rationale: The best endovascular therapy revascularization strategies for acute ischemic stroke caused by vertebral artery dissection (VAD) are unclear. We describes a case of basilar artery (BA) occlusion caused by extracranial VAD, in which we used a stent-retriever to achieve thrombectomy in the BA through the contralateral vertebral artery (VA). Patient concerns: A 32-year-old male presented with a sudden-onset headache accompanied by articulation disorder, left-sided weakness, and tinnitus in the left ear. Diagnosis: Digital subtraction angiography showed the V1 to V2 segment dissection of the left VA and occlusion of the BA. Interventions: Thrombectomy was performed through the thinner right VA with three passes of the Solitaire FR device 4 x 20 mm in the BA, and angiograms showed modified treatment in cerebral ischemia 3 reperfusion of BA and left VA V4 segment still occluded. Outcomes: The patient had a modified Rankin Scale of 2 at 90 days, and re-established blood flow of the left VA and BA. Lessons: When extracranial VAD complicated with BA occlusion, choosing the clean-road path to perform a BA thrombectomy may be a fast and effective treatment strategy.