RT Journal Article
SR Electronic
T1 Endovascular management of symptomatic vertebral artery origin stenosis in the presence of an acute thrombus
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP e11
OP e11
DO 10.1136/neurintsurg-2011-010038
VO 4
IS 4
A1 Adewumi O Amole
A1 Mehmet S Akdol
A1 Clint E Wood
A1 Salah G Keyrouz
A1 Eren Erdem
YR 2012
UL http://jnis.bmj.com/content/4/4/e11.abstract
AB A woman in her early 60s with hypertension and hyperlipidemia was undergoing investigations for anemia of unknown etiology. She developed a sudden reduction in visual acuity and bilateral visual field impairment. MRI and angiography revealed acute infarcts in the posterior circulation and severe narrowing of the left vertebral artery origin. Digital subtraction angiography demonstrated a high-grade stenosis of the left vertebral artery origin with a thrombus just distal to the stenosis. The patient developed recurrent infarcts while on antithrombotic therapy. The lesion was successfully treated by vertebral artery origin angioplasty and stenting (VOAS) using a flow reversal technique and distal embolic protection. She was discharged to a rehabilitation facility 4 days later without worsening or new neurological deficits. A search of the literature yielded a similar report managed with anticoagulation and subsequent VOAS after complete lysis of the thrombus. Our report highlights the technique, safety and feasibility of VOAS in the presence of a thrombus using a flow reversal technique and distal protection.