Acute basilar artery occlusion is one of the most devastating subtypes of ischemic stroke with an extremely high morbidity and mortality rate. The most common causes include embolism, large-artery atherosclerosis, penetrating small-artery disease, and arterial dissection. The heart and vertebral arteries are the main source of emboli in embolic basilar occlusions. The authors present an uncommon acute basilar occlusion secondary to a fusiform aneurysm with intraluminal thrombus. The patient underwent a mechanical thrombectomy with successful recanalization, but persistent intraluminal thrombus. The authors discuss the management dilemma and describe their choice for placement of flow diverter stents.The video can be found here: https://youtu.be/XzBdgxJPSWQ.

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http://dx.doi.org/10.3171/2019.1.FocusVid.18468DOI Listing

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