Endovascular treatment of vertebral artery (VA) origin stenosis typically requires placement of the proximal end of the stent within the lumen of the subclavian artery or aorta to provide complete coverage of the ostial lesion. This configuration may complicate subsequent endovascular access into the stented VA. We describe a technique modification of VA origin stenting and angioplasty with a monorail angioplasty balloon system designed specifically for dilation of the ostial origin which may be helpful in conforming the proximal portion of the stent to the VA origin. Simplified endovascular access to the VA origin after angioplasty is demonstrated.
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