LAUSR

BACKGROUND and Importance Unusual vascular anatomy can present treatment challenges as traditional approaches may be unfeasible. CLINICAL PRESENTATION In this case we describe a patient who presented with subarachnoid hemorrhage due to a ruptured basilar apex aneurysm, with an occluded left vertebral artery and severely stenotic right vertebral artery. Coil embolization was performed via catheterization of an ascending cervical artery, with a successful clinical and radiographic outcome. CONCLUSION This demonstrates novel use of an endovascular technique in the setting of multiple vascular pathologies.