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FIG 2. Case 8. A 55-year-old man with transient ischemic attack at presentation.
A, Initial left vertebral artery angiogram shows 95% stenosis of the intracranial vertebral artery.
B, Angiogram shows that the distal vertebral artery is straightened because of the stent-mounted catheter, and the lesion site is displaced more cranially (arrow). Primary stent deployment was attempted with a S660 2.5/9 stent; however, the distal end of the stent could not pass through the lesion site. Stent catheter was not retrieved because of concerns for acute thrombus formation. Notice the compromised flow in the basilar artery due to the trapped stent catheter.
C, Magnified angiographic view. After deployment of the initial stent (solid arrows) and additional careful angioplasty, a second stent-mounted catheter (dotted arrows) was navigated through the initial stent.
D, Magnified angiographic view. The second stent (dotted arrows) was deployed partially overlapping the initial stent (solid arrows) and covering the distal aspect of the lesion.
E, Final angiogram shows no residual stenosis.
F, Seventeen-month follow-up angiogram shows the patent stent site without significant restenosis.
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