Use of the Cross-Over Buddy Wire Technique for Coronary Stent Navigation to the Basilar Artery in Acute Ischemic Stroke Due to Basilar Artery Atherosclerotic Occlusion

OBJECTIVE: Several techniques have been reported for navigating devices to the basilar artery (BA). We report a case of acute BA reconstruction using the buddy wire technique to guide a coronary stent to the BA. CASE PRESENTATION: The patient was a 74-year-old man without a history of stroke. He suddenly developed quadriplegia and coma due to basilar artery occlusion (BAO). Although mechanical thrombectomy with a stent retriever and subsequent balloon angioplasty were performed repeatedly for residual severe stenosis, recanalization was not maintained. Recanalization with a coronary stent was attempted, but guidance was difficult because of the tortuous vertebral artery (VA). The stent was successfully guided to the BA by navigating two microguidewires as far as possible to the contralateral VA across the union. CONCLUSION: The cross-over buddy wire technique is a useful option for guiding a coronary stent to the BA.