With the rapid development of China’s social economy, people’s living standard is also increasing, however, the incidence of atherosclerotic cardiovascular and cerebrovascular diseases is also on the rise, and has become a common disease, multi-morbidity. Atherosclerosis will lead to gradual narrowing and occlusion of cerebral blood vessels, which may even cause death and disability. Recently, a special patient was admitted to our neurosurgery cerebrovascular group. The special feature of this patient is not only that he is 85 years old, but also has a combination of hypertension and diabetes mellitus, which are common in the elderly, and his condition is complicated and basic condition is poor. After detailed examination, the cause of this patient’s disease was clear: 90% stenosis of the right vertebral artery opening and multiple infarcts in the right cerebellum. The diagnosis was clear, but the treatment became a problem in front of everyone: due to the patient’s severe atherosclerosis and abnormal twisting of the blood vessels, if the interventional treatment was performed according to the conventional femoral artery approach, it would bring great risks to the operation. If the patient was treated with internal medicine, the consequences of vertebral artery occlusion would be unimaginable, because this vessel was the only lifeline of his entire cerebellar brainstem. Faced with such a difficult problem, the cerebrovascular group leader, Dr. Jieqing Wan, deputy chief physician, based on his rich clinical experience, after repeated consideration and rigorous argumentation, boldly drew on the radial artery approach of cardiology, combined with the special features of neurointervention, and proposed the plan of using the upper arm brachial artery approach for action vein stentoplasty. After comprehensive comparison, in order to minimize the risk and improve the patient’s benefit, the doctors of the neurosurgery cerebrovascular group decided to use the brachial artery access scheme to complete this case after many discussions, and reached an agreement with the family on the surgical plan. Finally, after the joint efforts of the treatment team, this surgery was completed very smoothly and the patient was discharged from the hospital in just two days. Usually, the conventional method of minimally invasive cerebrovascular intervention is the transfemoral approach, but this method has several disadvantages: 1. The distance from the puncture point to the diseased vessel is too far, especially in elderly patients because of the hardening and distortion of the vessel, which will make it difficult to get the surgical instruments in place; 2. To prevent bleeding at the puncture point after the operation, sandbag compression must be used for 6-8 hours, and bed rest and lower limb braking for at least 24 hours, which is very inconvenient, and 3. The pulsation of the femoral artery is strong, and even after complete hemostasis by the above methods, it may bleed again or even form a pseudoaneurysm; 4. The puncture site is near the groin, which may easily lead to infection. Compared with the traditional method, the biggest disadvantages of the brachial artery approach are: 1) it is technically difficult and not easy to master; 2) the diameter of the vessel is thin and not suitable for the passage of larger instruments. However, the advantages are particularly obvious in the elderly population: 1) the distance from the puncture site to the diseased vessel is shortened, and the curved aorta is avoided; 2) the bleeding can be completely stopped after the procedure by applying pressure with an elastic bandage for a few hours, and the patient can walk on the floor immediately with little or no effect on activity; 3) the brachial artery is thin, and the probability of rebleeding is minimal; 4) the puncture site is located in the forearm, which is less likely to lead to infection and has no effect on the patient’s privacy. It also has no effect on the patient’s privacy. It is reported that our neurosurgery cerebrovascular group is the first to use brachial artery access for minimally invasive interventions in Shanghai, and has accumulated rich experience and has successfully completed the procedure for dozens of cerebrovascular patients with good results.