PT - JOURNAL ARTICLE AU - Jesse Jones AU - Conrad William Liang AU - Nima Ramezan-Arab AU - Gary Duckwiler AU - Satoshi Tateshima TI - Nature’s Wastebasket: The Role of the External Carotid Artery in Acute Stroke AID - 10.1136/bcr-2017-013228 DP - 2018 Jan 15 TA - BMJ Case Reports PG - bcr-2017-013228 VI - 2017 4099 - http://casereports.bmj.com/content/2017/bcr-2017-013228.short 4100 - http://casereports.bmj.com/content/2017/bcr-2017-013228.full AB - 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.