In a remarkable medical achievement, doctors at Narayana Health City, Bengaluru successfully performed a rare and complex brain procedure that restored blood flow in a completely blocked artery, preventing potentially fatal strokes in a 53-year-old patient.

Led by Dr. Vikram Huded, Head of Neurology and Director of the Interventional Neurology Programme, the team performed what is believed to be the first successful recanalization of a Chronic Total Occlusion (CTO) in the vertebral artery origin in India.

This breakthrough procedure has set a new benchmark in the treatment of complex stroke cases.

A Patient’s Journey Through Repeated Strokes

The patient, a resident of Madurai, had already suffered three separate stroke episodes before seeking advanced treatment. Initial medical evaluation in Madurai revealed a critical condition.

Doctors discovered that:

His right vertebral artery was 100% blocked
His left vertebral artery was hypoplastic (underdeveloped) and unable to provide sufficient blood supply to the brain

The vertebral arteries are responsible for supplying blood to the posterior (back) part of the brain, which controls vital functions like balance, coordination, and vision. With one artery fully blocked and the other too small, the patient’s brain was receiving dangerously inadequate blood flow.

Recognizing the complexity and severity of the case, doctors in Madurai referred him to Narayana Health City, Bengaluru for specialized care.

The Challenge: Reopening a “Fossilized” Artery

Once the patient arrived, doctors conducted a Cerebral Angiogram (Digital Subtraction Angiography – DSA) to evaluate the blockage. The scan confirmed a chronic total occlusion, meaning the artery had been completely blocked for a long time.

Treating such blockages is extremely challenging because the artery essentially becomes “fossilized,” making it very difficult to reopen safely.

After reviewing global medical literature and discussing the risks extensively with the patient and his family, Dr. Huded and his team decided to attempt a highly specialized intervention.

According to Dr. Huded:

“The patient was experiencing repeated strokes because the remaining small artery simply could not compensate for the complete blockage on the right side. Reopening a long-standing occlusion like this is extremely challenging, but restoring blood flow was the only way to prevent further strokes.”

A “Back Door” Approach to Restore Blood Flow

Using advanced interventional neurology techniques, the team carefully navigated through the blocked artery and successfully performed recanalization, restoring normal blood flow to the brain.

This approach is sometimes referred to as a “back door” technique, where specialists find alternative pathways and advanced catheter-based methods to access and reopen blocked vessels.

The procedure was successfully completed, and the patient recovered well. After monitoring and treatment, he was discharged in stable condition.

Why This Case Matters

Posterior circulation strokes account for nearly 25% of all stroke cases, yet they are often misdiagnosed or overlooked because their symptoms can be subtle.

Common warning signs include:

Sudden dizziness
Loss of balance or coordination
Difficulty walking
Blurred or double vision
Sudden weakness or numbness

These symptoms are often dismissed as minor issues, delaying diagnosis and treatment.

A Critical Message: Don’t Ignore Stroke Symptoms

Dr. Huded emphasizes that recognizing early symptoms can be life-saving.

“Many patients ignore the warning signs of stroke. Even recurring dizziness or imbalance should not be neglected. Timely medical evaluation and specialized care can prevent permanent damage or even save lives.”

This successful procedure highlights how advances in interventional neurology are expanding treatment options for patients who previously had limited hope.

A New Benchmark in Stroke Care

By successfully treating a chronic total occlusion in the vertebral artery, the team at Narayana Health has demonstrated that even complex and long-standing blockages can be treated with the right expertise and technology.

The case marks an important milestone in stroke treatment in India, offering hope to patients suffering from recurrent strokes due to complex vascular conditions.