title: Manual aspiration thrombectomy through balloon-tipped guide catheter for rapid clot burden reduction in endovascular therapy for ICA L/T occlusion.
abstract: BACKGROUND
  Timely recanalization during endovascular procedures for acute ischemic stroke can be challenging in cases with large clot burden, such as those encountered in the terminal internal carotid T- or L-type occlusion.
  
  
  METHODS
  A novel but simple technique to achieve fast reduction in clot burden in stroke patients with occlusion of the internal carotid artery termination is described where manual suction using a 60-ml syringe applied through an 8-F balloon guide catheter positioned in the cervical carotid vasculature with proximal flow arrest allows subsequent revascularization of the residual middle cerebral artery clot.
  
  
  RESULTS
  The use of manual suction through a balloon-tipped guide catheter in internal carotid artery L- or T-type occlusion is illustrated. This resulted in a significant reduction of the clot burden and facilitated further interventions leading to full recanalization.
  
  
  CONCLUSIONS
  Manual suction using a 60-ml syringe through a balloon guide catheter is a useful and feasible technique that facilitates thrombectomy of large burden cerebral clots.
authors.affiliation: Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Muneer
authors.initials: M
authors.lastname: Eesa
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Almekhlafi
authors.forename: Alim P
authors.initials: AP
authors.lastname: Mitha
authors.forename: John H
authors.initials: JH
authors.lastname: Wong
authors.forename: Mayank
authors.initials: M
authors.lastname: Goyal
mesh_terms: D002341:Carotid Artery Thrombosis / Q000145:classification / Q000601:surgery*; D002343:Carotid Artery, Internal; D057785:Catheters; D004867:Equipment Design; D006801:Humans; D013396:Suction / Q000379:methods; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D013997:Time Factors