RT Journal Article SR Electronic T1 Nature’s Wastebasket: The Role of the External Carotid Artery in Acute Stroke JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2017-013228 DO 10.1136/bcr-2017-013228 VO 2017 A1 Jesse Jones A1 Conrad William Liang A1 Nima Ramezan-Arab A1 Gary Duckwiler A1 Satoshi Tateshima YR 2018 UL http://casereports.bmj.com/content/2017/bcr-2017-013228.abstract 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.