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Original research
Outcome of forced-suction thrombectomy in acute intracranial internal carotid occlusion
  1. Yang-Ha Hwang1,2,3,
  2. Dong-Hun Kang2,3,4,
  3. Yong-Won Kim1,2,
  4. Yong-Sun Kim2,3,4,
  5. Sung-Pa Park1,3,
  6. Chung-Kyu Suh1,2,3
  1. 1Department of Neurology, Kyungpook National University Hospital, Daegu, Republic of Korea
  2. 2Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Republic of Korea
  3. 3School of Medicine, Kyungpook National University, Daegu, Republic of Korea
  4. 4Department of Neuroradiology, Kyungpook National University Hospital, Daegu, Republic of Korea
  1. Correspondence to Professor Yang-Ha Hwang, Assistant Professor, Department of Neurology and Cerebrovascular Center, School of Medicine, Kyungpook National University Hospital, 130, Dongduk-ro, Jung-gu, Daegu 700-721, Republic of Korea; yangha.hwang{at}


Objectives Ischemic stroke from acute intracranial distal internal carotid artery (ICA) occlusion usually carries a poor prognosis. Despite the intra-arterial revascularization therapies, the results are still unsatisfactory. The aim of this study was to compare the outcomes between two endovascular techniques, the modified Penumbra System (mPS) and mechanical clot disruption (MCD), and to confirm the influence of recanalization on the outcomes.

Methods In a retrospective review of 39 consecutive cases of acute distal ICA occlusion, the recanalization rates and functional outcomes at 3 months of the two intra-arterial techniques during two consecutive periods (May 2006 to February 2009: MCD technique (n=19) vs March 2009 to August 2010: mPS technique (n=20)) were compared. Univariate and multivariate analyses were performed to determine the predictors of a favorable functional outcome.

Results The rate of successful recanalization (Thrombolysis In Cerebral Infarction score 2 or 3) was significantly higher in the mPS group than in the MCD group (85% (17/20) vs 32% (6/19); p=0.001). Favorable outcomes at 3 months (modified Rankin Scale score 0–2) were achieved in 9/20 and 3/19 in the mPS and MCD groups, respectively (45% vs 16%; p=0.048). Binary logistic regression analysis showed that younger age and successful recanalization were independent predictors of a favorable functional outcome.

Conclusions Forced-suction thrombectomy using the mPS technique may be a viable option for acute distal ICA occlusion and could result in more successful recanalization and a more positive clinical outcome.

  • Acute stroke
  • endovascular treatment
  • internal carotid artery
  • thrombectomy
  • stroke
  • aneurysm
  • thrombolysis
  • angiography
  • atherosclerosis
  • balloon
  • intervention
  • stent

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  • Y-HH and D-HK contributed equally to the study.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Kyungpook National University Hospital.

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