Complete removal of massive thrombus trapped in the common carotid artery in stages

With recent innovative aspiration catheters, even a large thrombus in the internal carotid artery can be removed at a high rate. Though, we still sometimes have difficulty absorbing hard and large thrombus. Here, we report a case in which we eliminated a massive thrombus stuck in the common carotid artery in multi-steps. Tremendously large thrombus trapped in the common carotid artery is extremely rare. The thrombus was first loosened and deformed with balloon compression and removed with several attempts with an aspiration catheter and a stent retriever to finish it off. The thrombus was much larger than the thickest balloon-guide catheter and we had to pull it out and introduce it again for each time. It required a lot of work but was less-invasive and effective.