Endovascular thrombectomy in a patient with ischemic stroke and vertebrobasilar dolichoectasia: A case report.

RATIONALE: Vertebrobasilar dolichoectasia (VBD) is a rare vascular disorder characterized by the dilation, elongation, and tortuosity of the vertebrobasilar artery; a condition which tends to culminate in an ischemic stroke. In cases of VBD complicated by ischemic strokes, reperfusion therapies include chemical thrombolysis and mechanical endovascular thrombectomy. The efficacy of endovascular therapy compared to that of pharmacological treatment in VBD-related ischemic stroke remains unclear. In this study, we present the case of a patient with VBD complicated by ischemic stroke who underwent thrombectomy, shedding light on the complexities and considerations involved in managing this condition.

PATIENT CONCERNS: This report presents a case of a 59-year-old male patient admitted with speech difficulties and altered perceptual capabilities. It is worth noting that this patient had a history of hypertension.

DIAGNOSES: Cranial and cervical computed tomography angiography (CTA) revealed aneurysmal dilation of the basilar artery with a filling defect, indicative of formation of a mural thrombus.

INTERVENTIONS: The patient underwent endovascular thrombectomy.

OUTCOMES: The patient succumbed to brainstem and bilateral cerebellar hemisphere infarctions, as well as obstructive hydrocephalus.

LESSONS: VBD is a rare condition, with ischemic stroke serving as its most common clinical presentation and cause of death. Although the superiority of endovascular therapy over thrombolysis for acute ischemic stroke caused by VBD is not yet established, endovascular interventions are recommended for patients presenting with moderate to severe symptoms. Overall, larger-scale clinical trials are essential to evaluate the safety and effectiveness of endovascular treatment for basilar artery occlusion.