A case report of successful intravenous thrombolysis bridged with percutaneous endovascular stent angioplasty

The mortality and disability rate of acute vertebral basilar artery occlusion remains very high. The main clinical manifestations are dizziness, numbness of the limbs and disordered activities, and even coma in serious conditions. The patient of this case was admitted for the main cause of “a transient sense of consciousness combined with weakness in left side of the limb for two hours”. Neurologic impairment score was 11 points at admission, in accordance with the scoring system of the National Institutes of Health (NIH) of the United States. Furthermore, mRS grading was five; and was diagnosed with acute cerebral infarction and occlusion of the main branch of the basilar artery. Alteplase was given for intravenous thrombolytic therapy. The patient’s condition improved once, aggravated again, and fell into a light coma state; but bleeding was excluded. This was considered as a re-occurrence of vascular occlusion, and emergent right vertebral artery stenting was performed. The patient was treated with antiplatelet, and subsequently received anticoagulation therapy. Then, the patient recovered and was discharged. This case revealed that thrombolytic therapy bridged with stenting can improve the vascular recanalization rate, and early vascular recanalization is the key to improve the prognosis.