RT Journal Article SR Electronic T1 A novel route of revascularization in basilar artery occlusion and review of the literature JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr2015011723 DO 10.1136/bcr-2015-011723 VO 2015 A1 Alejandro Morales A1 Phillip Vaughan Parry A1 Ashutosh Jadhav A1 Tudor Jovin YR 2015 UL http://casereports.bmj.com/content/2015/bcr-2015-011723.abstract AB Ischemia of the basilar artery is one of the most devastating types of arterial occlusive disease. Despite treatment of basilar artery occlusions (BAO) with intravenous tissue plasminogen activator, antiplatelet agents, intra-arterial therapy or a combination, fatality rates remain high. Aggressive recanalization with mechanical thrombectomy is therefore often necessary to preserve life. When direct access to the basilar trunk is not possible, exploration of chronically occluded vessels through collaterals with angioplasty and stenting creates access for manual aspiration. We describe the first report of retrograde vertebral artery (VA) revascularization using thyrocervical collaterals for anterograde mechanical aspiration of a BAO followed by stenting of the chronically occluded VA origin. Our novel retrograde–anterograde approach resulted in resolution of the patient's clinical stroke syndrome.