Bow Hunter's Syndrome from a Tortuous V1 Segment Vertebral Artery Treated with Stent Placement.

Abstract

Bow hunter's syndrome is a dynamic and reversible occlusion of the vertebral artery occurring after rotation or extension of the neck. The V3 segment is the most common site of compression, especially at the atlantoaxial joint. Surgical decompression with or without cervical fusion has been the mainstay of therapy. Endovascular intervention, such as placement of stents, is rarely performed. We report a patient with bow hunter's syndrome from tortuosity of the V1 segment of the VA treated with a self-expanding biliary stent placement. The symptoms where completely resolved by this treatment. Stent placement is a safe and effective option for V1 segment causes of Bow Hunter's syndrome, especially in absence of bony compression.