Fig. 2

Case studies illustrating the double aspiration technique. The initial angiogram on the left depicts a proximal occlusion of the right medial cerebral artery (a) in a 73-year-old female patient with an initial NIHSS of 8 and hemiparesis with predominant involvement of the left arm. A balloon guide catheter is advanced into the distal internal carotid artery and a distal aspiration catheter is pushed to the proximal end of the clot (b). The balloon is inflated and suction is applied to the distal aspiration catheter and to the BGC. The white arrow points at the inflated balloon of the BGC and the black arrow indicates the marker of the distal aspiration catheter on the roadmap image. The distal aspiration catheter is removed under constant proximal and distal aspiration. The control angiogram shows a complete recanalization of the treated vessel (c). The time between the event and groin puncture was 2 h 30 min