Subintimal recanalization for non-acute occlusion of intracranial vertebral artery in an emergency endovascular procedure:A case report  

作　　者：Jun-Feng Fu Xiang-Ling Zhang Shun-Yin Lee Fo-Ming Zhang Jin-Song You 

机构地区：[1]The Second Clinical College,Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong Province,China [2]Department of Neurosurgery,The Second Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2023年第24期5762-5771,共10页世界临床病例杂志

摘　　要：BACKGROUND Endovascular recanalization of non-acute intracranial artery occlusion is technically difficult,particularly when the microwire enters the subintima.Although the subintimal tracking and re-entry technique has been well established in the endovascular treatment of coronary artery occlusion,there is limited experience with its use in intracranial occlusion due to anatomical variations and a lack of dedicated devices.CASE SUMMARY A 74-year-old man was admitted to the hospital two days after experiencing acute weakness in both lower extremities,poor speech,and dizziness.After admission,imaging revealed acute ischemic stroke and non-acute occlusion of bilateral intracranial vertebral arteries(ICVAs).On the fourth day of admission,the patient's condition deteriorated and an emergency endovascular recanalization of the left ICVA was performed.During this procedure,a microwire was advanced in the subintima of the vessel wall and successfully reentered the distal true lumen.Two stents were implanted in the subintima.The patient's Modified Rankin Scale was 1 at three months postoperatively.CONCLUSION We present a technical case of subintimal recanalization for non-acute ICVA occlusion in an emergency endovascular procedure.However,we emphasize the necessity for caution when applying the subintimal tracking approach in intracranial occlusion due to the significant dangers involved.

关 键 词：Subintimal tracking and re-entry Large artery intracranial occlusive disease Chronic total occlusion Endovascular treatment Acute ischemic stroke Case report 

分 类 号：R774[医药卫生—眼科]