Stenting of a symptomatic long-segment extracranial vertebral artery occlusion

We present a 56-year-old man who presented with bilateral vertebral artery occlusions and recurrent transient ischemic attacks and strokes despite maximal medical therapy. A long-segment extracranial right vertebral occlusion was noted and successfully reconstructed with four drug-eluting stents. The patient has been symptom free for 3 months and does not exhibit restenosis on follow-up angiography. Stenting and angioplasty of a long-segment vertebral artery occlusion is technically feasible in select cases.