Bow Hunter's syndrome (BHS)

Q. Does endovascular treatment have a role in Bow Hunter’s Syndrome (BHS)?

A. Yes, especially in patient with contralateral vertebral artery stenosis. Angioplasty with and without stent might be enough. For patients with contralateral VA occlusion or hypoplasia, surgery is reasonable. The most common procedures are C1/C2 fusion and vertebral artery decompression.

The data of endovascular treatment for BHS is limited to small case series and case reports with limited long term follow up (2 weeks-14 months). Larger studies with long term follow up are needed to confirm the efficacy.

Reference
1) Zaidi HA, Albuquerque FC, Chowdhry SA, Zabramski JM, Ducruet AF, Spetzler RF.
Diagnosis and management of bow hunter's syndrome: 15-year experience at barrow neurological institute. World Neurosurg. 2014;82(5):733-738.
2) Motiei-Langroudi R, Griessenauer CJ, Alturki A, Adeeb N, Thomas AJ, Ogilvy CS. Bow
Hunter's Syndrome from a Tortuous V1 Segment Vertebral Artery Treated with Stent Placement. World Neurosurg. 2017;98:878.e11-878.e15.
3) Sugiu K, Agari T, Tokunaga K, Nishida A, Date I. Endovascular treatment for bow
hunter's syndrome: case report. Minim Invasive Neurosurg. 2009;52(4):193-195.
4) Georgiadis AL, Kim SH, Patel AI, Ellington KT, Qureshi AI. Stent placement to treat
positional occlusion of the vertebral artery: A report of two cases. J Vasc Interv Neurol. 2008;1(1):19-21.
5) Müller J, Hess J, Hager A. Minor symptoms of depression in patients with congenital
heart disease have a larger impact on quality of life than limited exercise capacity. Int J Cardiol. 2012;154(3):265-269.
6) Sugiu K, Agari T, Tokunaga K, Nishida A, Date I. Endovascular treatment for bow
hunter's syndrome: case report. Minim Invasive Neurosurg. 2009;52(4):193-195.
7) Darkhabani MZ, Thompson MC, Lazzaro MA, Taqi MA, Zaidat OO. Vertebral artery
stenting for the treatment of bow hunter's syndrome: report of 4 cases. J Stroke
Cerebrovasc Dis. 2012;21(8):908.e1-908.e9085.

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