Direct V2 vertebral artery puncture as rescue access for basilar thrombectomy: a technical note.

IF 2.8 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2026-10-06 DOI:10.1007/s00234-026-04205-3

François Lebeaupin, Brivaël Lemogne, Marc Lenfant, Heloïse Golea, Laura Baptiste, Frederic Ricolfi, Pierre-Olivier Comby

引用次数: 0

Abstract

Introduction: Basilar artery occlusion (BAO) treated with mechanical thrombectomy (MT) can be complicated by unfavorable supra-aortic anatomy precluding conventional transfemoral or trans-radial access.

Methods: We describe direct percutaneous vertebral artery (VA) puncture as a rescue strategy in three patients with BAO in whom conventional access failed because of chronic vertebral artery occlusion. Roadmap-guided puncture of the V2 segment allowed stent-retriever thrombectomy through a 4 F sheath.

Results: Reperfusion (mTICI 2b-2c) was achieved in all three patients, with favorable outcomes (6-month mRS 0-1) and no major access-site complications.

Conclusion: Direct V2 vertebral artery puncture is a viable, technically demanding rescue option for BAO, reserved for carefully selected patients at highly experienced comprehensive stroke centers.

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直接V2椎动脉穿刺作为基底动脉血栓切除术的抢救通道：技术注意事项。

导读：机械取栓术治疗基底动脉闭塞（BAO）可能会因主动脉上解剖结构不利而导致传统的经股或经桡动脉通道受阻而复杂化。方法：我们描述了直接经皮椎动脉（VA）穿刺作为三例BAO患者的抢救策略，这些患者由于慢性椎动脉闭塞而无法通过常规通道。路线图引导的V2段穿刺允许通过4f鞘进行支架取栓。结果：3例患者均实现了再灌注（mTICI 2b-2c），结果良好（6个月mRS 0-1），无主要通路部位并发症。结论：直接V2椎动脉穿刺是一种可行的、技术要求高的BAO抢救选择，保留给经验丰富的综合卒中中心精心挑选的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.