MT opens the door for a previously unaffected territory proximal to a lesion to be affected or for distal migration or distally within the target artery. The mechanism by which previously unaffected territories proximal to a lesion can be affected during MT occurs when clot is dragged from a distal location and thrombus fragments. An example of this occurs not uncommonly in the distal middle cerebral artery where a clot may be lodged. The removal of the clot requires travel proximaIly and in the midst of pulling clot, fragmentation may occur allowing thrombus to migrate into proximal lenticulostriate vessels or even to the anterior cerebral artery circulation. In distal embolization to new territory, the migrated clot can remain in the same vessel or break up and dissipate into many multiple tiny branches and possibly affect other surrounding vessel territories \cite{Papanagiotou_2016}. Distal embolization has been shown to be reduced with use of balloon guide catheters in conjuction with aspiration as the inflation of the balloon minimizes anterograde blood flow during clot retrieval in theory preventing clot fragments from travelling distally \cite{Stampfl_2016}.