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Nature’s Wastebasket: The Role of the External Carotid Artery in Acute Stroke
  1. Jesse Jones1,
  2. Conrad William Liang2,
  3. Nima Ramezan-Arab3,
  4. Gary Duckwiler1,
  5. Satoshi Tateshima1
  1. 1Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
  2. 2NeuroInterventional Surgery, Kaiser Permanente Fontana Medical Center, Fontana, California, USA
  3. 3Long Beach Memorial Medical Center, Long Beach, California, USA
  1. Correspondence to Dr Jesse Jones, jessegajones{at}


We describe a novel technical approach to acute stroke illustrated by the case of a 41 year old male who presented with tandem right common carotid artery (CCA) and M1 occlusions. His NIHSS was 17 and Alberta stroke programe early CT score (ASPECTs) was 8. Thrombectomy initially proved challenging due to large volume CCA thrombus that repeatedly occluded the aspiration catheters. However, by inflating a balloon distally and pulling clot into the adjacent ECA, we were able to quickly restore distal contrast flow to the intracranial circulation and achieve Thrombolysis In Cerebral Infarction/Arterial Occlusive Lesion (TICI2C/AOL3) revascularization.

  • Stroke
  • Intervention
  • Balloon
  • Thrombectomy

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  • Contributors All authors contributed to this manuscript in an academically meaningful way.

  • Competing interests None declared.

  • Patient consent Patient lost to follow-up; left the hospital against medical advice.

  • Provenance and peer review Not commissioned; externally peer reviewed.