Selective intra-arterial recombinant tissue-plasminogen activator in a case of acute posterior inferior cerebellar artery occlusion

Stroke is the third leading cause of death and the most common cause of serious long-term disability in the world. Posterior circulation ischemic stroke (PCIS) accounts for approximately 20% of the total number of ischemic strokes and is associated with high rates of morbidity and mortality [1]. Endovascular procedures in large-artery occlusions havebeen demonstrated to provide clinical beneft in selected patients with acute ischemic stroke. The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery and is one of the largest arteries in the brain. Despite the fact that PICA infarcts are rare, rapid clinical deterioration and sudden death may develop due to their presence[2]. Intravenous recombinant tissue-plasminogen activator (IV rt-PA) has been administered in cases of acute PICA occlusion. There is no case report about selective intraarterial rt-PA treatment in cases of acute PICA occlusion in the literature. In this case report, we show that selective intra-arterial rt-PA administration for acute PICA occlusion is safe and efective.