• Changchun Jiang, Jiahui Liu, Jinfeng Zhang, Yujuan Cui, Junfeng Yang, Fei Hao, Yu Fan, and Jianqi Wei.
• Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, China.
• Medicine (Baltimore). 2021 Nov 24; 100 (47): e27995e27995.

RationaleThe best endovascular therapy revascularization strategies for acute ischemic stroke caused by vertebral artery dissection (VAD) are unclear. We describes a case of basilar artery (BA) occlusion caused by extracranial VAD, in which we used a stent-retriever to achieve thrombectomy in the BA through the contralateral vertebral artery (VA).Patient ConcernsA 32-year-old male presented with a sudden-onset headache accompanied by articulation disorder, left-sided weakness, and tinnitus in the left ear.DiagnosisDigital subtraction angiography showed the V1 to V2 segment dissection of the left VA and occlusion of the BA.InterventionsThrombectomy was performed through the thinner right VA with three passes of the Solitaire FR device 4 × 20 mm in the BA, and angiograms showed modified treatment in cerebral ischemia 3 reperfusion of BA and left VA V4 segment still occluded.OutcomesThe patient had a modified Rankin Scale of 2 at 90 days, and re-established blood flow of the left VA and BA.LessonsWhen extracranial VAD complicated with BA occlusion, choosing the clean-road path to perform a BA thrombectomy may be a fast and effective treatment strategy.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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