A method of removing embolic material from a vessel with mechanical and aspiration assistance. The method comprises the steps of providing an aspiration catheter having a central lumen and a distal end, advancing the distal end of the aspiration catheter to obstructive material in a vessel, applying vacuum to the central lumen to draw clot into the central lumen, introducing a thrombus engagement tool into the central lumen, and manually manipulating the tip to engage clot between the tip and an inside wall of the central lumen.