Managing Embolized Vertebral Artery Stent – A Drag-Back Approach

Abstract

Ischemia involving the posterior cerebral circulation carries high morbidity and mortality. Endovascular access to the vertebral artery is a relatively safe and straightforward management option. The feasibility and safety of angioplasty and stenting is well demonstrated in multiple centers. Periprocedural risks include stent embolization, malposition, stent fracture, vessel rupture, dissection and thrombosis. We present a case of vertebral artery stenting that was complicated by distal embolization of the stent. The anatomical difficulties while managing the complication were challenging. A novel drag-back technique was successfully tried and is described here along with discussion of other management options described in literature.