Endovascular Treatment for Vertebral Artery Occlusion with Anterior Spinal Artery Involvement: Contrasting Outcomes in Two Cases

Lee, Chan Hyun; Kim, Soo-Kyoung; Choi, Nack-Cheon; Kim, Chang Hun

doi:2026.44.2.163

J Korean Neurol Assoc > Volume 44(2); 2026 > Article

Case Report

Journal of the Korean Neurological Association 2026;44(2): 163-167. doi: https://doi.org/10.17340/jkna.2026.0005

전방척수동맥 침범을 동반한 척추동맥폐색에서의 혈관 내 치료: 두 증례의 상반된 임상 결과

이찬현¹, 김수경^1,2, 최낙천^1,2, 김창헌^1,2

¹경상국립대학교 의과대학 경상국립대학교병원 신경과
²경상국립대학교병원 경남권역심뇌혈관센터

Endovascular Treatment for Vertebral Artery Occlusion with Anterior Spinal Artery Involvement: Contrasting Outcomes in Two Cases

Chan Hyun Lee MD¹, Soo-Kyoung Kim MD, PhD^1,2, Nack-Cheon Choi MD, PhD^1,2, Chang Hun Kim MD^1,2

¹Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
²Gyeongnam Regional Cerebrovascular Center, Gyeongsang National University Hospital, Jinju, Korea

Corresponding Author: Chang Hun Kim ,Tel: +82-55-750-9597, Fax: +82-55-755-1709, Email: honey0407@naver.com

*These authors contributed equally to this work

Received: January 13, 2026 Revised: February 20, 2026 Accepted: February 23, 2026 Published online: May 1, 2026

Abstract

Vertebral artery (VA) occlusion is often managed conservatively, but anterior spinal artery (ASA) involvement may cause rapid neurological deterioration. We report two contrasting cases of VA occlusion with ASA compromise. One patient achieved complete recovery after timely endovascular treatment (EVT) restoring ASA flow, whereas the other developed severe bilateral medial medullary infarctions following unsuccessful EVT. These cases highlight the prognostic importance of ASA involvement and suggest that EVT should be considered when ASA perfusion is threatened.

Key Words: Thrombectomy | Vertebral artery | Anterior spinal artery syndrome