Kissing Balloon Angioplasty for Subclavian Artery Combined with Vertebral Artery Origin Stenosis

Abstract

Clinical data The patient, a 74-year-old male, was admitted to our hospital due to "transient loss of consciousness and weakness of the right limb for 1 day".The patient had a sudden fall without obvious inducement 1 day ago, transient loss of consciousness combined with right limb weakness, gradually clear consciousness after about 5 minutes, left right limb weakness, and then went to our hospital.Physical examination on admission: right nasolabial sulcus, right upper limb muscle strength level 3, right lower limb muscle strength level 4, right Babinski sign positive.Right upper limb blood pressure 145/80mmhg, left upper limb blood pressure 123/73 mmHg.CTA at the top of the head after admission suggested left internal carotid artery occlusion, severe stenosis at the beginning of left subclavian artery and left vertebral artery.Mri scan of the brain reveals left lateral paraventricular infarction (not shown in this image).Color doppler ultrasound also suggested severe localized stenosis at the beginning of the left vertebral artery.After 5 days of oral administration of aspirin 100mg QD and Bolivar 75mg Qd, cerebral angiography and endovascular interventional therapy were performed.