Journal of Cerebrovascular and Endovascular Neurosurgery  2014;16(3):281-286

doi:10.7461/jcen.2014.16.3.281

Spontaneous Thrombolysis of Multiple Thrombi at Distal Region of Hypoplastic Vertebral Artery After Stent-assisted Angioplasty on Vertebral Artery Origin Stenosis: Angiographic Follow-up.

Hyung Seok KIM 1 ; Choon Woong HUH ; Dal Soo KIM ; Jin Ho MOK ; In Soo KIM ; Se Hwan KIM

Affiliations

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Keywords

Vertebral artery hypoplasia; Free floating thrombi; Endovascular treatment; Vertebral artery origin stenosis

Country

Republic of Korea

Language

English

Abstract

Vertebral artery hypoplasia (VAH) can be easily overlooked if the contralateral side vertebral artery is intact, because of compensation by the contralateral artery or cerebral collateral network. The clinical relevance and hemodynamic impact of VAH is still controversial. However, VAH has recently been considered a risk factor for posterior circulation ischemia. Ischemic stroke is seldom caused by free floating thrombi (FFT) in the artery. Pathophysiology of FFT has not yet been clarified. The state of reduced blood flow such as a vertebral artery origin stenosis may cause FFT. Their instability may make them sources of recurrent artery to artery embolism. Patients with FFT will require appropriate medical and endovascular treatment. The current case illustrates a short-term angiographic change of spontaneous thrombolysis of VAH and multiple thrombi at the distal region of the stenosed lesion after stent-assisted angioplasty for a vertebral artery origin stenosis.