![](https://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-08-ezgif.com-speed.gif)
Presenting with progressive decline in consciousness and mild weakness
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-01.png)
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-02.png)
Fantastic MCA-ACA-PCA leptomeningeal collaterals — enough to backfill the basilar… 🙂 how amazing is that — sometimes
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-03.png)
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-04.png)
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-05.png)
The top images below and the bottom VR images above were obtained before stenting, but after IV integrilin administration. Compare with the DSA pair above — before integrilin. See there is some clot just above the stenosis — that was contributing to acute decline. Ingrilin helps reopen the artery as long as there is clot to dissolve there.
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-06.png)
Onyx 3.5×8 stent
![](http://www.neuroangio.org/wp-content/uploads/Archives/Stroke/Intracranial-Stenting/Stenosis-Vert-4-stent/Archives-stroke-vert-stent-leptomeningeal-collaterals-stenting-07.png)