Case of a Patient Who Developed Basilar Artery Occlusion after Treatment of Traumatic Vertebral Artery Dissection with Proximal Coil Occlusion

Abstract

Objective: To examine a case of basilar artery (BA) occlusion caused by traumatic vertebral artery (VA) dissection after incomplete endovascular therapy.

Case Presentation: A 32-year-old man who got caught sustained injuries in a truck accident wherein he was stuck between two trucks was transported to a nearby hospital. Stenting was performed for the left common carotid artery (CCA). For left VA dissection, coil embolization of the VA was performed to prevent thromboembolic infarction because floating thrombus was found at the V3 segment. On postoperative day 1, he exhibited conscious disturbance. MRA revealed BA occlusion. Upon transfer to our hospital, thrombectomy was performed. After revascularization, the patient was alert.

Conclusion: Although optimal treatment of traumatic VA injury is still debated, proximal coil occlusion is regarded as an effective preventive treatment for thromboembolic stroke. In case of VA dissection with floating thrombus, proximal VA occlusion is insufficient to prevent thromboembolic stroke, and thrombus capture should be considered.