Intravascular ultrasound guided vertebral artery stenting after basilar artery thrombectomy for acute brain stem stroke.

A 64-year-old lady presented as right vertebral artery occlusion and brain stem stroke (Figure 1A). Emergent thrombectomy opened the artery, but it re-occluded 10 minutes later (Figure 1B,C). Intravascular ultrasound showed heavy plaque burden and guided a balloon-expandable stenting successfully (Figure 1D-F).