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 × 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.