Stent-Jack Technique for Ruptured Vertebral Artery Dissecting Aneurysm Involving the Origin of Posterior Inferior Cerebellar Artery

We herein report a case of a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery that was treated using the stent-jack technique. After parent artery occlusion of the distal vertebral artery, stenting of the posterior inferior cerebellar artery was performed. Further coiling was needed because distal vertebral artery recanalization occurred due to transformation of the coil mass. The stent-jack technique for a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery is effective; however, careful attention to recanalization after stenting is needed due to transformation of the coil mass

Endovascular Treatment for Basilar Artery Occlusion Caused by Radiation-induced Vertebral Artery Stenosis: Case Report

Objective: We report endovascular treatment of a patient with acute basilar artery occlusion considered to be due to an embolus from radiation-induced vertebral artery stenosis.Case Presentation: The patient was a 46-year-old male with a history of neck irradiation. He developed basilar artery occlusion. Temporary recanalization achieved by intravenous alteplase therapy and revascularization was followed by relapse. The origin of the vertebral artery was stenosed, and basilar artery was considered to have been embolized by a thrombus formed on the proximal side of the vertebral artery, where blood flow was stagnated due to reduced antegrade flow from the distal side of the stenotic vertebral artery and the increased collateral flow from the deep cervical artery. Recurrence of cerebellar infarction could be prevented by revascularization and occlusion of the parent artery.Conclusion: Acute basilar artery occlusion considered to be due to an embolus from radiation-induced vertebral artery stenosis is a rare condition, but it must be recognized as a possible cause of posterior circulation infarction