For intracranial mechanical thrombectomy, the direct-aspiration method, stent retrieval technique, or a combination of both methods was used. The direct-aspiration method refers to a forced arterial suction technique (FAST) that uses the Penumbra system (Penumbra Inc., Alameda, CA, USA).14 (link) The second-generation direct-aspiration system was defined as the Penumbra MAX system. In the stent retrieval technique, the clot is removed by capturing the thrombus and bringing it out of the body, using stent retrievers such as Solitaire AB/FR (Medtronic, Irvine, CA, USA) or Trevo (Stryker, Kalamazoo, MI, USA).1 (link)2 (link)15 (link) Balloon guide catheters such as Cello (Fuji System Corp., Tokyo, Japan) or Optimo (Tokai Medical Products, Aichi, Japan) were used to prevent clot migration by proximal balloon inflation while performing direct aspiration or stent retrieval.16 (link) Balloon guide catheters were occasionally used for the remote aspiration method by inflating the balloon and aspirating the guide catheter itself.17 (link)18 (link) Intracranial or extracranial angioplasty and/or stenting was sometimes performed at the discretion of physicians if necessary.