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The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects
Published on: October 2, 2014
Direct V2 vertebral artery puncture as rescue access for basilar thrombectomy: a technical note
François Lebeaupin1, Brivaël Lemogne2, Marc Lenfant2
1CHU Dijon Bourgogne, Department of Interventional Neuroradiology., Université Bourgogne Europe, Dijon, France. francois.lebeaupin@chu-dijon.fr.
Introduction:
Basilar artery occlusion (BAO) treated with mechanical thrombectomy (MT) can be complicated by unfavorable supra-aortic anatomy precluding conventional transfemoral or trans-radial access.
Methods:
We describe direct percutaneous vertebral artery (VA) puncture as a rescue strategy in three patients with BAO in whom conventional access failed because of chronic vertebral artery occlusion. Roadmap-guided puncture of the V2 segment allowed stent-retriever thrombectomy through a 4 F sheath.
Results:
Reperfusion (mTICI 2b-2c) was achieved in all three patients, with favorable outcomes (6-month mRS 0-1) and no major access-site complications.
Conclusion:
Direct V2 vertebral artery puncture is a viable, technically demanding rescue option for BAO, reserved for carefully selected patients at highly experienced comprehensive stroke centers.
