Original ArticleBrachial Artery Approach for Endovascular Treatment of Posterior Circulation Intracranial Vascular Disease: Technique and Application in 5 Cases
Section snippets
Patient 1
A 68-year-old woman presented with a history of subarachnoid hemorrhage due to rupture of a vertebrobasilar junction aneurysm. She had been treated initially at another institution with endovascular coil embolization, but suffered 2 recurrences of the aneurysm, due at least in part to an associated left subclavian artery occlusion and subclavian steal flow pattern, leading to retrograde flow in the left vertebral artery (VA). The left subclavian artery was opened with a stent before the second
Discussion
The standard transfemoral approach for vascular access cannot be used in an estimated 2%-10% of patients requiring selective cerebral angiography.1, 8, 9 Neuroendovascular examination and treatment by this route may be technically challenging or even impossible in patients with severe aortoiliac disease, history of iliofemoral bypass graft placement, aberrant aortic arch anatomy, or morbid obesity.10, 11, 12 Furthermore, as recent advances in endovascular techniques have expanded the scope of
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