{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:44:48Z","timestamp":1701132288420},"reference-count":14,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nVertebral artery origin stenosis (VAOS) is a major cause of ischemic stroke of the posterior circulation. Aggressive medical treatment using dual antiplatelet therapy is the most common treatment approach to symptomatic VAOS; however, the effectiveness of endovascular treatment (EVT) for VAOS has recently been reported. Here, we report a case of VAOS treated with percutaneous transluminal angioplasty (PTA) under flow reversal protection using Mo.MA\u2122<\/jats:sup> Ultra.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nThe patient was a 78-year-old man. He underwent mechanical thrombectomy for acute right posterior cerebral artery occlusion, and recanalization was achieved. Subsequently, artery-to-artery (A-to-A) embolism caused by the right VAOS was revealed as the etiology. PTA under the flow-reversal protection using Mo.MA\u2122<\/jats:sup> Ultra was performed electively, and the VAOS and antegrade flow of the right vertebral artery (VA) improved.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nIn EVT for symptomatic VAOS, lesion cross for distal protection device placement is considered to create a high risk of distal embolism due to the anatomic and clinicopathological characteristics of VAOS lesions, especially in A-to-A embolism cases. The flow-reversal protection using Mo.MA\u2122<\/jats:sup> Ultra can be performed with EVT to prevent distal embolism with lesion cross by retrograde flow of the VA. This method is feasible, especially for cases in which antegrade flow to the basilar artery through the developed contralateral VA is anticipated during the Mo.MA\u2122<\/jats:sup> Ultra protection.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_746_2023","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T05:36:03Z","timestamp":1701063363000},"page":"406","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous transluminal angioplasty for vertebral artery origin stenosis under the flow-reversal protection using Mo.MA\u2122<\/sup> Ultra: A technical case report"],"prefix":"10.25259","volume":"14","author":[{"given":"Fukutaro","family":"Ohgaki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagatsuki","family":"Tomura","sequence":"additional","affiliation":[{"name":"Department of Neuroendovascular Therapy, Yokohama Rosai Hospital, Yokohama, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Shuto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"10.25259\/SNI_746_2023\/ref-1","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/S1474-4422(19)30191-7","article-title":"Vertebral artery stenting: Lifting the therapeutic fog","volume":"18","author":"Chaturvedi","year":"2019","journal-title":"Lancet 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in the treatment of symptomatic vertebral artery-origin stenosis: A prospective randomized trial","volume":"154","author":"Wang","year":"2021","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_746_2023\/ref-11","doi-asserted-by":"crossref","first-page":"e1290","DOI":"10.1016\/j.wneu.2022.06.026","article-title":"A comparison of different endovascular treatment for vertebral artery origin stenosis","volume":"164","author":"Wang","year":"2022","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_746_2023\/ref-12","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1001\/archneur.55.4.470","article-title":"Proximal extracranial vertebral artery disease in the New England medical center posterior circulation registry","volume":"55","author":"Wityk","year":"1998","journal-title":"Arch Neurol"},{"key":"10.25259\/SNI_746_2023\/ref-13","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jocn.2022.12.004","article-title":"Using drug-coated balloons for symptomatic 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