{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:25:22Z","timestamp":1791293122299,"version":"4.1.0"},"reference-count":8,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,5]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>An 83-year-old man experienced left upper limb uncontrolled movements preceded by intense gasping during night rest, which progressed to unconsciousness and respiratory arrest requiring intubation. He was diagnosed with acute stroke due to distal occlusion of the basilar artery and received indication for endovascular thrombectomy. Standard endovascular approach includes percutaneous puncture of the femoral or radial arteries; however, the presence of unfavourable vascular anatomies (stenotic origin and tortuosity) did not allow catheterisation of the intracranial vessels through conventional access, and based on the consistent time lapse from onset of symptoms and deterioration of the clinical condition, a direct right vertebral artery ultrasound-guided puncture was performed. After one attempt of a triaxial technique, a complete recanalisation of the basilar artery and of its distal branches was achieved. Direct percutaneous puncture of the vertebral artery represents a rescue access strategy for treatment of posterior circulation stroke when other routes are not feasible.<\/jats:p>","DOI":"10.1136\/bcr-2020-238979","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T12:41:28Z","timestamp":1611664888000},"page":"e238979","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Direct ultrasound-guided puncture of vertebral artery V2 segment during mechanical thrombectomy"],"prefix":"10.1136","volume":"14","author":[{"given":"Vittorio","family":"Semeraro","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, Santissima Annunziata Hospital, Taranto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Gasparrini","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Imaging, University Hospital Policlinico Tor Vergata, Roma, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5982-4387","authenticated-orcid":false,"given":"Sofia","family":"Vidali","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Imaging, University Hospital Policlinico Tor Vergata, Roma, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gandini","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Imaging, University Hospital Policlinico Tor Vergata, Roma, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"2025082708374552000_14.1.e238979.1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493016676285"},{"key":"2025082708374552000_14.1.e238979.2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"2025082708374552000_14.1.e238979.3","article-title":"Arterial dissections complicating cerebral angiography and cerebrovascular interventions","volume":"21","author":"Cloft","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082708374552000_14.1.e238979.4","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000097195.48840.C4"},{"key":"2025082708374552000_14.1.e238979.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-006-0157-1"},{"key":"2025082708374552000_14.1.e238979.6","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-231335","article-title":"Direct puncture of the V3 segment of the vertebral artery in acute basilar artery stroke: an alternative approach in desperate circumstances","volume":"12","author":"O'Reilly","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082708374552000_14.1.e238979.7","doi-asserted-by":"publisher","DOI":"10.1177\/159101991201800104"},{"key":"2025082708374552000_14.1.e238979.8","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20785"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:37:52Z","timestamp":1756309072000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,26]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bcr-2020-238979"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238979","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}