Clot Meniscus Sign: An Angiographic Clue for Choosing between Stent Retriever and Contact Aspiration in Acute Basilar Artery Occlusion

Pre- (A) and post- (B) thrombectomy images of a basilar artery occlusion in a patient with the positive clot meniscus sign. Complete recanalization was achieved using a single attempt of contact aspiration. Pre- (C) and post- (D) thrombectomy images of a patient with a basilar artery occlusion with the negative clot meniscus sign. Following an unsuccessful first-line approach with contact aspiration, multiple attempts of rescue thrombectomy were performed with the stent retriever, revealing an underlying atherosclerotic stenosis (not shown). Recanalization was achieved by permanent stent placement.