Objective To investigate the short-term efficacy of the retrograde semi-retrieval technique(RESET)in the treatment of patients with acute intracranial large vessel occlusion.Methods This retrospective study involved 286 patients with acute intracranial large vessel occlusion who underwent mechanical thrombectomy using RESET at Tianjin Huanhu Hospital from November 2017 to March 2019.The patients were divided into two groups based on the presence or absence of intracranial atherosclerotic stenosis(ICAS):ICAS group(n=186,65％)and non-ICAS group(n=100,35％).Baseline characteristics,procedural outcomes,and 90-day modified Rankin Scale(mRS)scores were compared between the two groups.Results The two groups did not significantly differ in baseline characteristics,including age,gender,past medical history,on-admission National Institutes of Health Stroke Scale(NIHSS)score,and Alberta Stroke Program Early CT(ASPECT)score(all P＞0.05).Successful vascular recanalization was achieved in 272 patients(95.1％),with 209 patients(73.1％)achieving complete recanalization with a single thrombectomy attempt.Rescue therapy was required in 33 patients(11.5％).Two patients in the ICAS group died due to postoperative symptomatic intracranial hemorrhage,and one patient in the non-ICAS group died due to postoperative multiple organ failure.Compared with the non-ICAS group,the ICAS group had a significantly longer puncture-to-recanalization time[141.36(124.11,156.53)min vs.65.17(53.92,83.25)min,P＜0.001]but a significantly smaller number of thrombectomy attempts[1.00(1.00,1.00)vs.1.00(1.00,2.00),P=0.002].However,there were no significant differences between the two groups in terms of final recanalization rate,complete recanalization rate with a single thrombectomy attempt,distal embolism or embolization of new territory,symptomatic intracranial hemorrhage,perioperative death,or 90-day mRS score(all P＞0.05).Conclusion RESET demonstrates satisfactory short-term efficacy in the treatment of acute intracranial large vessel occlusion.The number of thrombectomy attempts required for complete recanalization is significantly lower in the ICAS group than in the non-ICAS group,suggesting that RESET is particularly suitable for patients with ICAS.

Objective To investigate the short-term efficacy of the retrograde semi-retrieval technique(RESET)in the treatment of patients with acute intracranial large vessel occlusion.Methods This retrospective study involved 286 patients with acute intracranial large vessel occlusion who underwent mechanical thrombectomy using RESET at Tianjin Huanhu Hospital from November 2017 to March 2019.The patients were divided into two groups based on the presence or absence of intracranial atherosclerotic stenosis(ICAS):ICAS group(n=186,65％)and non-ICAS group(n=100,35％).Baseline characteristics,procedural outcomes,and 90-day modified Rankin Scale(mRS)scores were compared between the two groups.Results The two groups did not significantly differ in baseline characteristics,including age,gender,past medical history,on-admission National Institutes of Health Stroke Scale(NIHSS)score,and Alberta Stroke Program Early CT(ASPECT)score(all P＞0.05).Successful vascular recanalization was achieved in 272 patients(95.1％),with 209 patients(73.1％)achieving complete recanalization with a single thrombectomy attempt.Rescue therapy was required in 33 patients(11.5％).Two patients in the ICAS group died due to postoperative symptomatic intracranial hemorrhage,and one patient in the non-ICAS group died due to postoperative multiple organ failure.Compared with the non-ICAS group,the ICAS group had a significantly longer puncture-to-recanalization time[141.36(124.11,156.53)min vs.65.17(53.92,83.25)min,P＜0.001]but a significantly smaller number of thrombectomy attempts[1.00(1.00,1.00)vs.1.00(1.00,2.00),P=0.002].However,there were no significant differences between the two groups in terms of final recanalization rate,complete recanalization rate with a single thrombectomy attempt,distal embolism or embolization of new territory,symptomatic intracranial hemorrhage,perioperative death,or 90-day mRS score(all P＞0.05).Conclusion RESET demonstrates satisfactory short-term efficacy in the treatment of acute intracranial large vessel occlusion.The number of thrombectomy attempts required for complete recanalization is significantly lower in the ICAS group than in the non-ICAS group,suggesting that RESET is particularly suitable for patients with ICAS.

Tandem occlusion of the anterior circulation is a specific acute large vessel occlusion, which is defined in most of the literature as a combination of intracranial large vessel occlusion and high degree of stenosis or occlusion of the ipsilateral extracranial internal carotid artery.Tandem occlusion is presented in approximately 15% patients with acute ischemic stroke in the anterior circulation who receive endovascular treatment. In patients with tandem occlusion, endovascular treatment is more effective than drug therapy; however, controversy still exists regarding the optimal management strategy of endovascular treatment. This article reviews the recent advance in endovascular treatment of tandem occlusion in the anterior circulation in recent years, to improve the overall care standard for acute ischemic stroke with tandem occlusion of the anterior circulation.

OBJECTIVETo study the techniques and efficacy of neuronavigation-guided puncture and drainage in the treatment of brain abscesses.

METHODSFrom February 2006 to December 2012, 31 patients with brain abscesses treated by the technique of neuronavigation-guided puncture and drainage were retrospectively analyzed. There were 27 male and 4 female patients, age ranged from 10 months to 69 years, average (34 ± 19) years.Single brain abscesses were found in 26 patients, multiple abscesses in 5 patients. The abscesses were located in eloquent regions in 19 patients. The mean diameter of the abscess was 4.1 cm (2.5-6.7 cm). The first follow-up visit was on the first month after surgery, and if residual was observed on enhanced MRI, then the patient was followed up every 3 months until the abscess disappeared completely. After residual absorbed, the patient was followed up every year.

RESULTSIncisions of all patients were healed well and no infection. The length of hospital stay after surgery was 6-42 days, mean (14 ± 9) days. Bacterial culture of pus was performed regularly including aerobic, anaerobic and fungal culture after surgery. Thirteen patients had positive culture whereas the other 18 patients had negative culture. The duration of antibiotic use was 18-42 days, mean (22 ± 5) days. All the patients were followed up for 3 months to 3 years. Twenty-nine patients recovered well postoperatively, 1 case died 2 months after operation.One case was performed the second drainage after 10 days from the first surgery.Eighteen patients showed the improvement of neurological status within the first day following surgery, 4 patients got improvement in the next day, 1 patient with hemiplegia showed improvement in 10 days postoperatively, 1 patient with aphasia recovered gradually after 1 month, 1 patient with hemiplegia showed deterioration temporarily after surgery, and recovered gradually after 15 days.

CONCLUSIONThe technique of puncture and drainage guided by neuronavigation has many advantages to treat brain abscesses, such as small trauma, short operation time, high accuracy and safety, simple surgical procedures and good prognosis.

Adolescent ; Adult ; Aged ; Brain Abscess ; therapy ; Child ; Child, Preschool ; Drainage ; methods ; Female ; Humans ; Infant ; Male ; Middle Aged ; Neuronavigation ; Retrospective Studies ; Young Adult