PMC8901581_01
Magnetic resonance imaging (MRI) before intervention. (a,b) TOF shows the stop of flow signal in the distal basilar artery (arrow in a and double arrow in (b), and a discontinuous flow signal in the proximal basilar artery (arrowheads); (c) diffusion-weighted imaging (DWI) MRI signal elevation and ADC decrease (d) in the cerebellum corresponding to SCA territory without significant FLAIR changes (e). Only small diffusion restriction in the brain stem (medulla oblongata).
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F1
PMC8901581_02
(a) Initial finding of distal basilar artery occlusion (arrow); (b) super selective injection into left PCA; (c) proximal occlusion after the 1st retriever maneuver (open arrow); (d) deployment of Preset device (white arrowheads); (e) finding after the 2nd retrieval with vasospasm (black arrowheads); and (f) final control after nimodipine infusion.
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F2
Bilateral subtraction angiography confirmed the distal occlusion of the hypoplastic BA (Figure 2). Montmorency, France), and the thrombus passage was confirmed by a contrast injection showing a distal position in the left posterior cerebral artery (Figure 2b). MT was performed with a Catch Mini 3 x15 mm (Balt, Montmorency, France) that was deployed within the occlusion.
PMC8901581_03
(a,b) MRI on day 1, after the intervention, shows bright DWI lesions in both SCA territories with small brain stem involvement; (c) TOF proves patent hypoplastic basilar artery; (d,e) MRI on day 15 shows normalization of DWI signal and decrease in the FLAIR lesion in the cerebellum; and (f) missing proximal flow signal in left VA.
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F3
There was no increase in the volume of DWI abnormalities (Figure 3). Postinterventional follow-up imaging with MRI (day 1 and 15) and a transcranial ultrasound showed a proximal occlusion of the left VA, which had been catheterized during the intervention (Figure 3f).
Three months following up of MRI and MRA. Postischemic defects in bilateral SCA territory with focal atrophy in the cerebellum on the following: (a) FLAIR (white arrow); (b,c) T2w (black arrows), proximal vertebral artery shows no antegrade flow in v0-V2 with distal reperfusion; (d,e) white double arrows; and (f) the basilar artery shows normal flow signal.
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F4
The MRI showed a normal perfused basilar artery without signs of new ischemia (Figure 4).