%0 Journal Article %A Ameer E Hassan %A Rani Ramsey Rabah %A Wondwossen Tekle %T Intracranial pellet embolization: an endovascular endeavor %D 2019 %R 10.1136/bcr-2019-015301 %J BMJ Case Reports %P e015301 %V 12 %N 12 %X A 44-year-old man was referred to the neurointerventionalist 6 hours after sustaining a shotgun wound to the left chest, shoulder, and neck from 4 feet away. Physical examination of the chest showed a 5 cm × 5 cm gunshot entry wound on the anterior-superior aspect of the chest involving the supraclavicular and infraclavicular region, with multiple gunshot pellet entry sites riddled in the surrounding vicinity. The patient was taken for a CT scan of the brain without contrast and CT angiography, which showed no sign of stroke or intracranial hemorrhage but revealed a single 'buckshot' pellet embolizing the basilar artery tip, occluding the origin of the left posterior cerebral artery. Using A Direct Aspiration First Pass Technique (ADAPT), the neurointerventinalist was able to endovascularly remove the embolized pellet and the patient was discharged 8 days later with no focal neurological deficit. %U https://casereports.bmj.com/content/bmjcr/12/12/e015301.full.pdf