Basilar artery recanalization by proximal balloon occlusion and aspiration in a single vessel vertebrobasilar system: A case report

Matthew Gusler; Seyed-Mostafa Razavi; Aaron Grossman; Charles Prestigiacomo; Ashkan Mowla; Peyman Shirani

doi:10.4103/bc.bc_79_22

Basilar artery recanalization by proximal balloon occlusion and aspiration in a single vessel vertebrobasilar system: A case report

Brain Circ. 2023 Jun 30;9(2):103-106. doi: 10.4103/bc.bc_79_22. eCollection 2023 Apr-Jun.

Authors

Matthew Gusler¹, Seyed-Mostafa Razavi², Aaron Grossman^{3

4}, Charles Prestigiacomo³, Ashkan Mowla⁵, Peyman Shirani^{3

4}

Affiliations

¹ Department of Neurology, University of Virginia, Charlottesville, VA, USA.
² Department of Neurology, University of New Mexico, Albuquerque, NM, USA.
³ Department of Neurosurgery, University of Cincinnati, OH, USA.
⁴ Department of Neurology, University of Cincinnati, OH, USA.
⁵ Department of Neurosurgery, University of Southern California, CA, USA.

Abstract

The authors present a case of a patient with a hypoplastic right vertebral artery (VA) ending in the posterior inferior cerebellar artery who sustained an acute onset basilar artery occlusion. A balloon-guided catheter was used to proximally occlude the dominant left VA, and aspiration was applied until reversal of flow was achieved in the basilar artery. Thus, basilar artery reperfusion was achieved without the need for stent-retrieval thrombectomy. We believe this represents the first described case of successful thrombectomy in the vertebrobasilar system using only proximal artery occlusion and aspiration. This novel technique may decrease the time to recanalization and improve outcomes for patients with acute basilar artery occlusion in the setting of a hypoplastic contralateral VA.

Keywords: Balloon angioplasty; basilar artery; interventional neuroradiology.

Publication types

Case Reports