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We explored the clinical impact of PO after mechanical thrombectomy (MT). Patients who underwent MT to treat distal ICA occlusions between July 2012 and March 2018 were reviewed. A cICA-PO was defined as when single phase computed tomography angiography (CTA) revealed a gradual decline in contrast above the level of the carotid bulb. We investigated the relationship between a cICA-PO and outcome; we also explored the association between successful recanalization and outcome. Among 71 patients, 40 (56.3%) exhibited cICA-PO and more likely to experience poor outcomes (80.0% vs. 25.8%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), hemorrhagic transformation (32.5% vs. 9.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.01), and a lower rate of successful recanalization (65.0% vs. 90.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.014) than the non-PO group. In binary logistic regression, a cICA-PO was independently associated with a poor outcome (odds ratio, 4.278; 95% CI, 1.080\u201333.006; <jats:italic>P<\/jats:italic>\u2009=\u20090.045). In the cICA-PO group, all patients who failed recanalization (n\u2009=\u200915) experienced poor outcomes, as did 69.2% of patients in whom recanalization was successful (<jats:italic>P<\/jats:italic>\u2009=\u20090.018). cICA-POs are common and have worse outcomes than non-PO patients. Patients with cICA-POs are more likely to exhibit poor outcomes after MT, particularly when recanalization fails.<\/jats:p>","DOI":"10.1038\/s41598-020-59609-9","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T11:06:26Z","timestamp":1583406386000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pseudo-Occlusion of the Internal Carotid Artery in Acute Ischemic Stroke: Clinical Outcome after Mechanical Thrombectomy"],"prefix":"10.1038","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0727-3744","authenticated-orcid":false,"given":"Woo Sang","family":"Jung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Soo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sten","family":"Solander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2396-4705","authenticated-orcid":false,"given":"Jin Wook","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"59609_CR1","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1056\/NEJMoa1414792","volume":"372","author":"BC Campbell","year":"2015","unstructured":"Campbell, B. 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