In contrast to data clearly supporting thrombectomy for distal carotid terminus occlusion, complete occlusion of the cervical ICA typically makes mechanical thrombectomy more dangerous.  Existing studies suggest chronic total occlusions should receive medical management alone, while there is emerging data to support consideration for selective intervention for acute complete cervical carotid occlusions. It is often difficult to assess the chronicity of a complete occlusion without access to previous imaging. 

Pseudo-occlusion is a phenomenon where a CT angiogram has the appearance of a complete occlusion of the cervical ICA due to distally impeded flow. In this case, the cervical ICA is open, and the occlusion involves the distal intracranial carotid artery. Mistaking a pseudo-occlusion for a true occlusion could lead doctors to avoid thrombectomy, leading to poor patient outcomes.