In this LINNC Paris 2024 case, Dr. Apoorvi Shah presents a complex and unexpected complication during stenting for critical stenosis in the left V4 segment of a 76-year-old male patient with multiple risk factors, including hypertension, diabetes, and atrial fibrillation. Despite challenges with tortuous anatomy and difficult vessel access, the team successfully deployed a stent from the proximal basilar artery to the distal V4. However, a sudden basilar artery clot formed, requiring mechanical thrombectomy. Watch the video to see how the team handled this complex case!