Mechanical Thrombectomy in Basilar Artery Stroke Attributable to Persistent Primitive Proatlantal Intersegmental Artery: A Case Report.

Objective: This clinical note describes a patient who presented with acute basilar artery occlusion and a persistent primitive proatlantal artery. Case Presentation: We present the case of an 82-year-old woman who presented with sudden onset of left-sided weakness. Cross-sectional imaging revealed occlusion of the basilar artery with a persistent primitive proatlantal artery. She then underwent successful mechanical thrombectomy. Complete reperfusion was achieved; thereafter, she recovered well from the ischemic stroke and was discharged home. Discharge modified Rankin Scale score was <2. Conclusion: This is the first case report of mechanical thrombectomy in a patient with persistent primitive proatlantal artery. Embryonic carotid vertebral anastomosis rarely persists in adult patients. Prompt and accurate recognition of these persistent embryonic anastomoses is of paramount importance in interpreting cross-sectional imaging and planning revascularization procedures.