Endovascular recanalization for chronic vertebrobasilar artery occlusion guided by high-resolution magnetic resonance vessel wall imaging-based"virtual road map"
LIN Ai-long
WANG Zhi-zhong
CHEN Ying-chun
YAO Xiao-long
LI Jun
Abstract：Objective To investigate the feasibility and effectiveness of endovascular recanalization for chronic vertebrobasilar artery occlusion under the guidance of a"virtual road map"based on high-resolution magnetic resonance vessel wall imaging(HRMR-VWI).Methods The clinical data of 5 patients with chronic vertebrobasilar artery occlusion who underwent endovascular recanalization between May 2023 and May 2024 were retrospectively analyzed.The entire vertebrobasilar artery was identified using HRMR-VWI,and the occluded arterial segment was reconstructed.Magnetic resonance angiography(MRA),computed tomography angiography(CTA),and digital subtraction angiography(DSA)images were anatomically aligned and fused.The fused images served as a"virtual road map"for intraoperative guidance,visualizing the occluded arterial segment to direct interventional procedures.Results HR-MRI vessel wall imaging clearly displayed the vessel wall and lumen of the occluded arterial segment.The fused images accurately represented anatomical locations,fully visualized the target occluded arterial segment,and effectively guided the interventional operations.Successful recanalization was achieved in all cases,with immediate post-procedural angiography showing TICI grade of 2b was achieved 3 cases and grade 3 in 2 cases.None of the patients experienced new stroke-related complications after the procedure.During the follow-up period of 3 to 12 months,no new neurological deficits were observed.Angiographic follow-up in 3 cases confirmed maintained patency of the recanalized vessels.Modified Rankin Scale(mRS)scores at three months post-operation were 0 in two cases and 1 in three cases.Conclusion HRMR-VWI combined with multimodal image fusion enables accurate three-dimensional visualization during surgery and guides interventional procedures,thereby improving the success rate of recanalization for chronic vertebrobasilar artery occlusion,reducing complications,and enhancing patient outcomes.
Keywords：Chronic vertebrobasilar artery occlusionEndovascular recanalizationHigh-resolution magnetic resonance vessel wall imagingVirtual road map
Publication Date：2025-07-25
Online Publishing Date：2025-09-28(First online date of this platform, not the publication date of the document)
Pages：6( 385-390 )