Objective To investigate the clinical feasibility and safety of direct aspiration thrombectomy used as a preferred strategy for patients with acute posterior circulation-large vessel occlusion(PC-LVO).Methods The patients with acute PC-LVO,who received direct aspiration therapy as the preferred thrombectomy strategy at the Department of Neurology,Baise Municipal People's Hospital of China from January 2020 to December 2022,were enrolled in this study.The baseline data were collected from all the included patients,and the surgical procedure and related parameters were recorded,the clinical effectiveness,safety and prognosis were evaluated.Results A total of 36 patients were included in this study with an average age of 61.31 years,and 75.0％of them were males.The median time from the onset of disease to the perform of puncturing was 419.5 minutes,and the median time from puncturing to vessel recanalization was 60 minutes.The vascular recanalization rate was up to 91.7％,the incidence of symptomatic intracranial hemorrhage was 11.1％,and the incidence of operation-related complications was 8.3％.The postoperative 90-day good prognosis(mRS score ≤3 points)was obtained in 41.7％of patients,and the mortality rate was 25％.Conclusion For patients with acute PC-LVO,direct aspiration therapy used as the preferred strategy of mechanical thrombectomy has a high vascular recanalization rate and an acceptable safety.