Objective To explore the effect of prominent cortical vein(PCV)sign on the clinical prognosis of patients undergoing endovascular recanalization for acute anterior circulation cerebral infarction.Methods A total of 102 patients with acute anterior circulation large-vessel occlusion in Zhongshan Municipal Hospital of Tradiontional Chinese Medicine from January 1,2020 to December 21,2022,who received endovascular recanalization,were enrolled in this study.The clinical data and radiographic materials were collected.According to whether PCV sign was present or not,the patients were divided into PCV group and non-PCV group.The clinical data were compared between the two groups.Logistic regression analysis was used to analyze the correlation between the postoperative 90-day mRS score and the occurrence of PCV.Results Compared with non-PCV group,in PCV group the incidence of atrial fibrillation was even higher,and the good rate of collateral compensation was even lower,and the postoperative(7±2)-day NIHSS score was even lower;the differences in above indexes between the two groups were statistically significant(all P＜0.05).Ninety days after treatment,the proportion of patients having modified Rankin Scale(mRS)score ≤2 points in the non-PCV group was 76.3％,which was higher than 58.6％in the PCV group,but the difference was not statistically significant(P=0.074).Logistic regression analysis indicated that a positive correlation existed between the presence of PCV sign and atrial fibrillation(OR=9.679,95％CI=1.264-74.364)and a negative correlation existed between the presence of PCV sign and good collateral compensation(OR=0.015,95％CI=0.033-0.331).No relationship existed between the postoperative 90-day good prognosis and the presence of preoperative PCV sign(OR=2.078,95％CI=0.680-6.348),but patient's age,preoperative intravenous thrombolysis were negatively correlated with the preoperative Alberta Stroke Program Early CT(ASPECT)score(P＜0.005).Conclusion In patients with anterior circulation acute ischemic stroke(AIS),the occurrence of PCV sign is associated with the impaired collateral compensation and atrial fibrillation,but its impact on the clinical outcomes of patients after receiving reperfusion therapy remains uncertain.PCV sign may be used as a potential evaluation indicator for inadequate cerebrovascular collateral compensation.

Objective:To investigate the risk factors for futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy (EMT), and establish a nomogram model predicting futile recanalization in these patients.Methods:One hundred and eighty-eight patients with acute anterior circulation large vessel occlusion after EMT were enrolled from Department of Neurology, Zhongshan Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine from January 2018 to December 2021. Patients were divided into futile recanalization group and effective recanalization group according to whether futile recanalization occurred; futile recanalization was defined as successful recanalization showed by immediate postoperative DSA (modified thrombolysis in cerebral infarction [mTICI] ≥2b), but poor functional outcome (modified Rankin Scale [mRS] scores>2 90 d after surgery). The clinical data were compared between futile recanalization group and effective recanalization group. Multivariate Logistic regression analysis was used to screen the risk factors for futile recanalization. R software was used to establish a nomogram model for futile recanalization. C-index was used to evaluate the differentiation of the model, and correction curve was used to evaluate the accuracy of the line graph model prediction. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of the nomogram model.Results:Ninety-two patients had futile recanalization. Compared with the effective recanalization group, futile recanalization group had significantly older age, significantly higher hemoglobin A1c on admission, significantly longer time from puncture to vascular recanalization, significantly higher proportions of patients with hypertension history and poor collateral circulation, and significantly different severities of stroke and white matter hyperintensities (WMHs) and distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that age, history of hypertension, time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke were independent risk factors for futile recanalization after EMT in patients with acute anterior circulation large vessel occlusion ( P<0.05). A nomogram model of futile recanalization was established according to the above 6 factors, with C-index of 0.862 ( 95%CI: 0.809-0.914); the calibration curve of the model was highly coordinated to the ideal model curve; area under the ROC curve of futile recanalization was 0.862 ( 95%CI: 0.809-0.914, P<0.001). Conclusions:Acute anterior circulation large vessel occlusion patients with older age, history of hypertension, longer time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke trend to have futile recanalization after EMT. This nomogram can predict futile recanalization after EMT.

Objective:To investigate the safety and effectiveness of Solitaire FR with intracranial support catheter for mechanical thrombectomy (SWIM) in the treatment of cerebral venous sinus thrombosis (CVST).Methods:Patients with progressive CVST treated with SWIM technology in the Neurology Department, Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from June 2019 to March 2022 (including 4 patients with intracranial hemorrhage) were retrospectively included. The venous sinus recanalization after procedure and during follow-up was observed. The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after procedure.Results:A total of 9 patients with progressive CVST were treated with SWIM technology, including 6 males with a median age of 37.0 years (range, 15-78). Immediately post-procedural angiography showed complete recanalization of the venous sinuses in 6 cases and partial recanalization in 3 cases. At 3 months after procedure, the mRS score showed that 3 cases was 0, 3 cases was 1, 2 cases was 2, and 1 case was 4.Conclusion:SWIM technology may be a safe and effective method in the treatment of progressive CVST.

Objective To compare the accuracy of diagnostic peritoneal lavage (DPL),abdominal computed tomographic(CT) scanning,and abdominal B ultrasound for the diagnosis of blunt abdominal trauma. Methods Prospective study was made on 61 hemodynamically stable abdominal injury patients.The patients received both CT and B ultrasound before DPL ,A laparotomy was done on the condition that one of the three examinations had positive finding.The surgical findings were compared with that of the diagnostic studies. Results The sensitivity,specificity and accuracy were 97.4%,81.7% and 91.8% for DPL; 97.3% 91.3% ,and 95.1% for CT;and 92.3%,90.9% and 91.8% for B ultrasound.Although the sesitivity,specificity,and accuracy of B ultrasound in the diagnosis of blunt abdominal trauma were similar to DPL and CT, B ultrasound had more advantages than DPL and CT. Conclusions B ultrasound can replace DPL.CT as a supplementary method in the diagnosis of blunt abdominal trauma.