Mechanical thrombectomy of basilar artery fenestration

CASE PRESENTATION

• A 66-year-old male patient arrives at the emergency neuro department with onset of mild right-side weakness, drift, vertigo, and deafness in right ear.
• Upon examination, he was given a score of NIHSS 8: dysarthria, horizontal rotatory nystagmus, central facioparesis, GMS 4/5, retropulsion in Romberg, right hand dysmetria
• Emergency CT, without ischemia:

• Emboli/clot in right limb of basilar artery fenestration on CT angio:

• DSA image verifying emboli in the right limb of basilar fenestration, also right AICA is not showing:

TREATMENT APPROACH

• Aspiration cath in front of emboli:

• Clot and aspiration catheter:

RESULTS

• Post-procedure DSA, TICI 3 revascularisation, with now right AICA present as well:

• Control CT, small ischemia of right cerebellum:

• Upon MT patient recovered to NIHSS 0, also noted that his deafness resolved as well

RETURN TO THE STROKE SPECIAL REPORT