A once in a lifetime case by Vera Sharashidze. Another one where knowing anatomy helps save lives. See Trigeminal Artery Page for background

Note enlarged (rather than occluded) basilar artery distal to confluence with the trigeminal (arrow). The embolus is higher, at basilar bifurcation

Took 4 passes, with Red 62 and Freeclimb 54, with Tenzing in them both

Note embolus flipping into the left P1. Maybe not what you wanted, but it makes it easier to aspirate now

Final angio

Final CT

Below are two collages with the case summarized

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