Revascularization for failed carotid artery stenting in a patient with a rare vertebral artery anomaly

There is a growing cohort of patients requiring complex revascularization for failed carotid artery stenting. This revascularization can be complex in patients with coexisting supra-aortic vascular anomalies. Aberrant origin of the vertebral artery (VA) is an example of such an anomaly. Although VA anomalies are rare, their occurrence is of significant importance in endovascular and open vascular procedures. We report a case of a 78-year-old man with rare VA anomaly, whose left internal carotid artery ostium was inadvertently covered during a carotid artery stenting procedure. We discuss the carotid artery revascularization in this patient as well as the relevant literature.