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Updated: Jun 24, 2026

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
08:22

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Published on: July 21, 2013

[Vertebrobasilar occlusions : Pathophysiology, diagnostics and treatment]

J Fiehler1, G Thomalla

  • 1Klinik und Poliklinik für neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland. fiehler@uke.uni-hamburg.de

Der Radiologe
|March 14, 2009
PubMed

Insights

Acute vertebrobasilar occlusions (VBO) are life-threatening emergencies. Prompt diagnosis and endovascular treatment are crucial for improving outcomes in posterior circulation stroke.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Interventional Neuroradiology

Context:

  • Acute vertebrobasilar occlusions (VBO) carry a high mortality rate (up to 90%) with standard medical care.
  • Immediate diagnosis of vessel status is critical upon suspicion of VBO.

Purpose:

  • To review the clinical and pathophysiological details essential for decision-making in acute VBO management.
  • To highlight the diagnostic equivalence of CT/CTA and MRI/MRA in the emergency setting.
  • To discuss endovascular treatment as the established therapy for posterior circulation VBO.

Summary:

  • CT/CTA and MRI/MRA are equivalent diagnostic tools for acute VBO.
  • Endovascular therapy is preferred for posterior circulation VBO, especially with residual stenosis after fibrinolysis.
  • Systemic fibrinolysis followed by transport for local therapy ('drip and ship') is an option when neurointerventional centers are not immediately accessible.

Impact:

  • Emphasizes the importance of profound clinical and pathophysiological knowledge for optimal neurointerventional therapy.
  • Aims to guide clinicians in making critical treatment decisions for acute VBO.
  • Contributes to improving patient outcomes in severe stroke cases.

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