Zenith devices used in this case:

Patient Information

• Male, 65 years old
• Dizziness for three days, worsening one day prior, accompanied by transient left limb weakness lasting approximately 5 minutes.
• Blood pressure: 180/98 mmHg
• Conscious and alert, fluent speech
• Muscle strength: 5/5 in all limbs, normal muscle tone
• Negative bilateral Babinski signs (-)

Preoperative Examination

Head CT: Lacunar infarction and cerebral atrophy

Head & Neck CTA:

Devices

• 5F vertebral artery angiographic catheter
• 125 5F multipurpose angiographic catheter
• 5F Zenith Long Sheath
• 5F Zenith Distal Access Catheter
• 014 Balt Microguide Wire
• 5-8 Apollo Stent
• 6F occlusion device

Procedure

Left Subclavian Artery Angiography:

Identified tortuous, elongated basilar artery with fenestration and severe proximal stenosis.

5F Zenith Long Sheath and 5F Zenith Distal Access Catheter were advanced coaxially to the left vertebral artery V4 segment. Under roadmap guidance, the microguide wire successfully navigated through the fenestration and stenotic segment into the distal basilar artery.

Stent Deployment

Postoperative Angiography

AP and lateral views:

AP and lateral views:

Surgeon Information

Zhiyi Liu, Honghao Li and Hongru Deng, The First People’s Hospital of Shenyang