Combination approach of retrograde and antegrade for recanalization of long chronic vertebral artery occlusion without stump of the artery ostium: A novel endovascular technique case report

Abstract Stenosis of the extracranial vertebral artery (VA) is known to contribute to approximately 32% of posterior circulation stroke and carries a high risk of recurrence. However, currently, there is no clear consensus on the optimal therapeutic options for treating this condition. Open surgical options, previously used, are now less favored due to their high rates of morbidity and mortality. Fortunately, the advancement of endovascular interventions has made it possible to perform endovascular reconstruction of extracranial VA lesions. The author presented a case of long chronic extracranial VA occlusion (CEVAO) successfully recanalized without a stump of the artery ostium using a combination of retrograde and antegrade approaches. In selected patients, it is technically feasible to perform endovascular revascularization of long CEVAO without any remaining remnants of the artery ostium by combining retrograde and antegrade approaches.