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Although the Penumbra System (PS) is the most promising device in terms of recanalization rate, the PS cannot recanalize all cases, especially when clot is too hard, or if clot is located on tortuous segment of vessel. Under such circumstances, we simply modified the PS, identified certain advantages, and applied this as a primary modality for recanalization. Direct wedging between the tip of reperfusion catheter and the clot followed by forceful suction using a 50 cc syringe is a unique feature of this technique. Recently, a 45-year-old male of TICI 0 occlusion of the left MCA was completely recanalized (TICI 3) from single forceful suction of this technique. The interval from arterial puncture to revascularization was 12 minutes and 27 mm-sized entire clot was retrieved from the procedure.

Directly Retrieved Entire Clot from Forced Suction Thrombectomy Using the Penumbra System in Acute Middle Cerebral Artery Occlusion