Retrograde endovascular revascularization for chronic total occlusion of the internal carotid artery: a case report

Endovascular revascularization of a chronically occluded internal carotid artery (ICA) is challenging because the occlusive segment can be long and tortuous. A case is presented of a successful recanalization of a chronically occluded ICA by retrograde passing of a guidewire from the intracranial ICA to the cervical ICA via the posterior communicating artery. This case suggests that a retrograde approach for reopening an occluded artery may be useful during neurovascular interventions, similar to percutaneous coronary interventions. In this patient, daily transient ischemic attacks disappeared after successful recanalization of the ICA.