Comparing a novel Catfish flow restoration device and the Solitaire stent retriever for thrombectomy revascularisation in emergent largevessel occlusion stroke:a prospective randomised controlled study

Background The Catfish stent retriever is a newly developed mechanical thrombectomy device for rapid recanalisation in emergent large vessel occlusion(ELVO)stroke.The current trial aimed to assess whether the Catfish stent retriever is non-inferior to the Solitaire stent retriever in terms of outcomes in ELVO stroke.Methods This was a randomised,prospective,parallel-group,multicentre,open-label,non-inferiority study conducted at 18 sites in China.The primary outcome was the proportion of cases with successful recanalisation(modified thrombolysis in cerebral infarction score of 2b or 3)following the procedure.Secondary efficacy outcomes included the National Institutes of Health Stroke Scale scores at 24 hours and 7 days or discharge if earlier,time from artery puncture to successful recanalisation and good clinical outcome(modified Rankin scale score≤2)at 90 days.Safety outcomes included symptomatic intracranial haemorrhage,all cause-death and severe adverse events at 90 days.Results Between 3 March 2019 and 5 June 2021,118 and 120 patients were randomly allocated to the Catfish and Solitaire groups,respectively.The primary endpoint after all endovascular procedures was non-inferior in the Catfish group(88.5%,100/113)than in the Solitaire group(87.7%,100/114),with a rate difference(RD)of 0.78%(95%CI-7.64 to-9.20;p=0.001).Sensitivity analysis only considering the per-protocol set also yielded similar results,with an RD of 0.83%(95%CI-7.03 to-8.70;p<0.001).Additionally,the proportions of cases with good clinical outcomes(47.8%vs 50.0%,p=0.739)and all-cause death rates(17.7%vs 18.8%,p=0.700)were similar in both groups at 90 days.Conclusions The Catfish stent retriever is an effective and safe device for endovascular recanalisation in ELVO stroke..

A comparison between acute large vessel occlusion in the posterior circulation and anterior circulation after endovascular treatment:the ANGEL-ACT registry experience

Background and purpose Endovascular treatment(EVT)has shown an overwhelming benefit for acute anterior circulation artery occlusion(ACO).Whether it can achieve the same outcomes in posterior circulation artery occlusion(PCO)has not been well explained.We aimed to evaluate the characteristics and prognosis of ACO and PCO after EVT in a nationwide registry.Method The present analysis was based on the prospective ANGEL-ACT Registry in China between November 2017 and March 2019.Demographic data,periprocedural times,recanalisation rate,intracranial haemorrhage(ICH)and 90-day functional outcomes were compared between the ACO and PCO groups.Results A total of 1793 patients were analysed including 397(22.1%)consecutive patients with PCO and 1396(77.9%)patients with ACO treated with EVT.A larger proportion of patients with PCO had intracranial atherosclerotic disease and received extra angioplasty during EVT.Successful recanalisation and 90-day favourable functional outcomes did not differ significantly between the two groups.Patients with PCO showed lower 24-hour ICH and symptomatic ICH rates.There was a trend towards higher mortality rate in the PCO group(22.09%vs 14.44%;adjusted OR 1.286(95%CI 0.820 to 2.017),p=0.2731),especially when the onset to puncture time was over 6 hours(30.77%vs 11.13%;adjusted OR 2.673(95%CI 1.280 to 5.583),p=0.0089,interactive p=0.0002).Conclusions In this large prospective multicentre registry,there was a significant difference in the characteristics and periprocedural features between patients with PCO and ACO.However,successful recanalisation and 90-day favourable functional outcomes in PCO were equivalent to those in ACO.

Magnetic resonance imaging findings in Lhermitte-Duclos disease:reports of three cases

Lhermitte-Duclos disease （LDD）, or dysplastic gangliocytoma of the cerebellum, is a rarehamartomatous lesion characterized by a slowly enlarging mass within the cerebellar cortex. The disease reveals unique appearance on magnetic resonance imaging （MRI）. Recognition of the imaging features makes the correct diagnosis possible even without a pathological examination. Three cases are presented and analyzed in this report.

Tuberous sclerosis complex complicated with extraventricular cystic giant cell astrocytoma:case report

Tuberous sclerosis complex （TSC） is one of the most commonly identified neurocutaneous disorders with a prevalence of 1/6000 to 1/9000 in general population. In the patients with TSC, 10%-15% have subependymal giant cell astrocytoma （SGCA） .