Cerebral angiography directly visualizes to‐and‐fro stream of vertebral artery stump syndrome

Tempaku, Akira

doi:10.1002/jgf2.114

Cited by 7 publications

(8 citation statements)

References 4 publications

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“…We treated 3 patients with VASS through EVT, which was effective in preventing recurrent strokes. Although some reports have shown that dual antiplatelet and anticoagulant therapies are effective for VASS [ 1 , 9 , 10 ], others have reported cases that were refractory to these therapies [ 1 , 3 ]. Therefore, an appropriate medical therapy for VASS has not been established.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment May Be Effective in Preventing Recurrence of Ischemic Stroke in Vertebral Artery Stump Syndrome: A Case Series

Sakisuka,

Morita,

Tanaka

et al. 2024

Neurointervention

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Vertebral artery stump syndrome (VASS) is a rare condition that can cause posterior circulation ischemic stroke due to occlusion of the ipsilateral vertebral artery (VA) orifice, resulting in blood flow stagnation and embolus formation. Although there is no established treatment for this condition, we observed 3 cases of VASS out of 326 acute ischemic stroke cases at a single institution from April 2021 to October 2022. Despite the best possible antithrombotic treatment, all 3 patients had recurrent ischemic strokes. One patient underwent drug-eluting stenting of the VA orifice to relieve occlusive flow. The other 2 patients received coil embolization, which resulted in the disappearance of their culprit collateral flow. None of the patients had recurrent ischemic strokes after endovascular intervention. Based on our observations, stenting and coil embolization are effective methods for preventing future recurrences of VASS.

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Section: Discussionmentioning

confidence: 99%

Endovascular Treatment May Be Effective in Preventing Recurrence of Ischemic Stroke in Vertebral Artery Stump Syndrome: A Case Series

Sakisuka,

Morita,

Tanaka

et al. 2024

Neurointervention

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“…This anastomosis caused antegrade flow in the proximal side of the VA whose origin was occluded although the detailed fatal mechanism was unclear. [ 14 , 15 ] From this hypothesis, anticoagulation therapy may be effective for the prevention of recurrent ischemic events in VASS[ 9 ] as seen in a report of 12 such cases. [ 8 ] In that report, 1.2% of PC strokes were VASS-related, indicating that VASS is not a rare cause of PC stroke, but, since it is not recognized as causative for PC stroke, scarce reports exist.…”

Section: Discussionmentioning

confidence: 99%

Fatal recurrent ischemic stroke caused by vertebral artery stump syndrome

Yamano

Nakai

Akutagawa

et al. 2021

Surgical Neurology International

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Background: Vertebral artery stump syndrome (VASS) develops into recurrent posterior circulation ischemic stroke after ipsilateral vertebral artery (VA) occlusion at its origin. Case Description: The patient was a 46-year-old man with the right posterior cerebral artery occlusion. We used a recombinant tissue plasminogen activator (rt-PA) and then performed mechanical thrombectomy using a stent retriever. Angiography revealed left VA occlusion and stagnant flow to the left VA from the right deep cervical artery; therefore, we diagnosed VASS. Within 24 h of the rt-PA injection, the symptoms had dramatically improved, and so we avoided additional antithrombotic agents. Only 13 h later, the patient developed a basilar artery occlusion and died in spite of a repeated mechanical thrombectomy. Conclusion: Vigilance against early (and sometimes fatal) recurrent stroke induced by VASS is required.

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“…6 Previous reports have suggested several treatments such as antiplatelet therapy, anticoagulant therapy and endovascular intervention. 2,4–7 However, the most effective treatment for VASS has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…Four case reports involving seven patients with VASS have been published to date (Table 1). 4,5,7,8 Six patients were men and one patient was a woman. The mean age at the time of presentation was 64 years.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transluminal angioplasty for suspected vertebral artery stump syndrome

Oda

Noda²,

Ishibashi

et al. 2020

Neuroradiol J

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Vertebral artery stump syndrome is a rare disease associated with a posterior circulation stroke after vertebral artery origin occlusion. However, few reports have addressed its management. We herein present a case involving a patient with vertebral artery stump syndrome who underwent successful intravascular intervention. We also present a literature review of previous cases of this rare disease. The present case involved a 91-year-old man with acute onset of vertigo and disturbance of consciousness. Diffusion-weighted imaging showed an acute ischaemic stroke in the bilateral cerebellar hemispheres. Magnetic resonance angiography revealed left vertebral artery origin occlusion. Angiography detected a nearly occluded left vertebral artery site, with distal antegrade collateral flow via the deep cervical artery at the C6 level. We observed intravascular stasis at the proximal end of the left vertebral artery via the collateral flow. We performed percutaneous transluminal angioplasty towards the occluded left vertebral artery site. The flow from the left vertebral artery was significantly improved. This is the first report of percutaneous transluminal angioplasty performed for vertebral artery stump syndrome. Although vertebral artery stump syndrome has a high risk of recurrence and a poor prognosis, endovascular intervention showed a better outcome than pharmacotherapy in our patient. However, such cases are rare and further investigations are needed.

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Cerebral angiography directly visualizes to‐and‐fro stream of vertebral artery stump syndrome

Cited by 7 publications

References 4 publications

Endovascular Treatment May Be Effective in Preventing Recurrence of Ischemic Stroke in Vertebral Artery Stump Syndrome: A Case Series

Endovascular Treatment May Be Effective in Preventing Recurrence of Ischemic Stroke in Vertebral Artery Stump Syndrome: A Case Series

Fatal recurrent ischemic stroke caused by vertebral artery stump syndrome

Percutaneous transluminal angioplasty for suspected vertebral artery stump syndrome

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