A Case of Coil Embolization with Retrograde Stenting for Ruptured Vertebral Artery Dissecting Aneurysm Ipsilateral to Brachiocephalic Artery Occlusion

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Objective: We encountered a rare case of steal phenomenon via the vertebral artery due to occlusion of the brachiocephalic artery that developed dissecting aneurysm in the right vertebral artery and suffered subarachnoid hemorrhage.

Case Presentation: A 68-year-old woman was transported due to headache and disturbance of consciousness. Close examinations disclosed subarachnoid hemorrhage, dissecting aneurysm of the right vertebral artery, occlusion at the origin of the brachiocephalic artery, and consequent steal phenomenon. After a stent was placed retrogradely from the right posterior inferior cerebellar artery to the union of the two vertebral arteries via the left vertebral artery, coil embolization was performed.

Conclusion: For ruptured vertebral artery dissecting aneurysm ipsilateral to occlusion of the brachiocephalic artery, coil embolization was performed after retrograde stenting. This procedure is considered to have been useful as a radical endovascular treatment to preserve the parent artery and prevent re-rupture of the aneurysm.