Endovascular stenting of an acutely thrombosed basilar artery: technical case report and review of the literature

Neurosurgery. 1999 Mar;44(3):667-73. doi: 10.1097/00006123-199903000-00134.


Objective and importance: The goal of this report was to describe the successful percutaneous endovascular use of a Gianturco-Roubin-2 coronary stent in the treatment of an acute atherothrombotic occlusion of the basilar artery. To our knowledge, the percutaneous endovascular deployment of an intra-arterial stent for the treatment of an acute atherothrombotic occlusion of the basilar artery and the percutaneous endovascular placement of a Gianturco-Roubin-2 stent in the basilar artery have not been previously reported.

Clinical presentation: An 83-year-old man presented with a recurrent, transient, locked-in syndrome resulting from a lower basilar artery occlusion caused by vertebrobasilar thrombosis superimposed on severe proximal basilar artery atheromatous stenosis.

Intervention: After successful superselective intra-arterial thrombolysis of the vertebrobasilar clot, balloon angioplasty of the underlying basilar artery stenosis was performed, without significant angiographic improvement. Percutaneous endovascular deployment of a Gianturco-Roubin-2 coronary stent of 4-mm diameter was subsequently performed, with excellent angiographic results.

Conclusion: The patient made a very good neurological recovery but unfortunately died as a result of cardiogenic shock and sepsis. Detailed neuropathological follow-up results are presented; stent patency was revealed in the postmortem examination. The anatomic and pathophysiological considerations of basilar artery stent placement for the treatment of acute basilar artery occlusion related to atherosclerotic stenosis are discussed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon
  • Basilar Artery / diagnostic imaging
  • Basilar Artery / surgery*
  • Cerebral Angiography
  • Fatal Outcome
  • Humans
  • Intracranial Embolism and Thrombosis / complications
  • Intracranial Embolism and Thrombosis / diagnostic imaging
  • Intracranial Embolism and Thrombosis / surgery*
  • Male
  • Quadriplegia / complications
  • Stents*