Background: Unusual vascular anatomy can present treatment challenges as traditional approaches may be unfeasible.
Case description: 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.
Conclusions: This demonstrates novel use of an endovascular technique in the setting of multiple vascular pathologies.
Keywords: Aneurysm; Angiography; Catheter; Hemorrhage; Subarachnoid.
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