{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:16:00Z","timestamp":1770351360542,"version":"3.49.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,16]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Vertebral artery (VA) size, anatomy, and occlusion status should be considered when selecting endovascular access for basilar artery mechanical thrombectomy. In a patient with concomitant basilar artery and VA occlusion and a patent but hypoplastic contralateral VA, the occluded VA should be selected. The authors report a technique that utilizes advancing a guiding sheath with attached dilator via an occluded VA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 65-year-old male presented with disturbed consciousness because of an acute infarction of the brainstem and cerebellum caused by a basilar artery occlusion. Cerebral angiography showed a hypoplastic right VA and occlusion of the left VA at the origin. A regular wire was easily advanced through the occlusion and a 4-Fr diagnostic catheter was advanced into the distal left VA. A 6-Fr guiding sheath with attached dilator was placed in the left VA beyond the occlusion by exchanging it over a long wire. After removing the basilar artery thrombus, balloon angioplasty was performed at the left VA origin. Complete revascularization of the posterior circulation was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>A guiding sheath with dilator can advance across and dilate a VA occlusion at the origin to provide rapid access to the basilar artery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case22480","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T03:08:52Z","timestamp":1673838532000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute reperfusion therapy via occluded vertebral artery using a guiding sheath for posterior circulation tandem occlusion: illustrative case"],"prefix":"10.3171","volume":"5","author":[{"given":"Kohei","family":"Ishikawa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and"},{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and"},{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and"},{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daishi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and"},{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"20","key":"b1","series-title":"N Engl J Med","first-page":"1910","article-title":"Endovascular therapy for stroke due to basilar-artery occlusion","volume":"384","author":"Langezaal LCM","year":"2021","unstructured":"Langezaal LCM, van der Hoeven EJRJ, Mont\u2019Alverne FJA,  Endovascular therapy for stroke due to basilar-artery occlusion. N Engl J Med. 2021;384(20):1910\u20131920.34010530"},{"issue":"3","key":"b2","series-title":"Clin Neuroradiol","first-page":"435","article-title":"Revascularization techniques for acute basilar artery occlusion: technical considerations and outcome in the setting of severe posterior circulation steno-occlusive disease","volume":"29","author":"Siebert E","year":"2019","unstructured":"Siebert E, Bohner G, Zweynert S,  Revascularization techniques for acute basilar artery occlusion: technical considerations and outcome in the setting of severe posterior circulation steno-occlusive disease. Clin Neuroradiol. 2019;29(3):435\u2013443.29651586"},{"issue":"11","key":"b3","series-title":"N Engl J Med","first-page":"1009","article-title":"Endovascular therapy for ischemic stroke with perfusion-imaging selection","volume":"372","author":"Campbell BC","year":"2015","unstructured":"Campbell BC, Mitchell PJ, Kleinig TJ,  Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009\u20131018.25671797"},{"issue":"6","key":"b4","series-title":"Stroke","first-page":"1883","article-title":"Mechanical thrombectomy for tandem vertebrobasilar stroke: characteristics and treatment outcome","volume":"51","author":"Baik SH","year":"2020","unstructured":"Baik SH, Jung C, Kim BM, Kim DJ. Mechanical thrombectomy for tandem vertebrobasilar stroke: characteristics and treatment outcome. Stroke. 2020;51(6):1883\u20131885.32404041"},{"issue":"1-2","key":"b5","series-title":"J Neurol Sci","first-page":"74","article-title":"Vertebral artery stump syndrome in acute ischemic stroke","volume":"324","author":"Kawano H","year":"2013","unstructured":"Kawano H, Inatomi Y, Hirano T, Yonehara T. Vertebral artery stump syndrome in acute ischemic stroke. J Neurol Sci. 2013;324(1-2):74\u201379.23110982"},{"key":"b6","series-title":"J Clin Neurosci","first-page":"70","article-title":"Emergent revascularization of acute tandem vertebrobasilar occlusions: Endovascular approaches and technical considerations-Confirming the role of vertebral artery ostium stenosis as a cause of vertebrobasilar stroke","volume":"34","author":"Cohen JE","year":"2016","unstructured":"Cohen JE, Leker RR, Gomori JM,  Emergent revascularization of acute tandem vertebrobasilar occlusions: Endovascular approaches and technical considerations-Confirming the role of vertebral artery ostium stenosis as a cause of vertebrobasilar stroke. 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Neuroradiology. 2020;62(7):867\u2013876."},{"key":"b9","series-title":"J Clin Neurosci","first-page":"299","article-title":"A thread of hope for successful revascularization for acute embolic basilar artery occlusion due to miserable vertebral artery stump syndrome. A technical report","volume":"73","author":"Maeoka R","year":"2020","unstructured":"Maeoka R, Nakagawa I, Ohnishi H, Kuga Y, Nakase H, Ohnishi H. A thread of hope for successful revascularization for acute embolic basilar artery occlusion due to miserable vertebral artery stump syndrome. A technical report. J Clin Neurosci. 2020; 73:299\u2013303.31983643"},{"issue":"5","key":"b10","series-title":"Stroke Vasc Neurol","first-page":"462","article-title":"Retrograde recanalisation for vertebral artery stump syndrome: a case report","volume":"7","author":"Ji R","year":"2022","unstructured":"Ji R, Li B, Xu Z. Retrograde recanalisation for vertebral artery stump syndrome: a case report. 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J Clin Neurosci. 2016;34:70\u201376.27522497"},{"key":"b7","series-title":"Clin Neurol Neurosurg","first-page":"106154","article-title":"Posterior circulation tandem occlusions: classification and techniques","volume":"198","author":"Weinberg JH","year":"2020","unstructured":"Weinberg JH, Sweid A, Sajja K,  Posterior circulation tandem occlusions: classification and techniques. Clin Neurol Neurosurg. 2020;198:106154.32829201"},{"issue":"7","key":"b8","series-title":"Neuroradiology","first-page":"867","article-title":"The \u201cdistal-to-proximal\u201d strategy for the treatment of posterior circulation tandem occlusions: a single-centre experience","volume":"62","author":"Xing PF","year":"2020","unstructured":"Xing PF, Zhang YW, Li ZF,  The \u201cdistal-to-proximal\u201d strategy for the treatment of posterior circulation tandem occlusions: a single-centre experience. 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