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Early and late complications can lead to revision surgeries with partial or complete DBS-system removal. In this study, we aimed to report on our experience with a frameless x-ray-based lead re-implantation technique after partial hardware removal or dysfunction of DBS-system, allowing the preservation of intracerebral trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe a surgical procedure with complete implant removal due to infection except for the intracranial part of the electrode and with non-stereotactic electrode re-implantation. A retrospective analysis of a patient series treated using this technique was performed and the surgical outcome was evaluated including radiological and clinical parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 8 DBS-patients with lead re-implantation using the frameless x-ray-based method were enrolled in the study. A revision of 14 leads was performed, whereof a successful lead re-implantation could be achieved without any problems in 10 leads (71%). In two patients (one patient with dystonia and one patient with tremor), the procedure was not successful, so we placed both leads frame-based stereotactically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The described x-ray-based technique allows a reliable frameless electrode re-implantation after infection and electrode dysfunction and might represent an efficient alternative to frame-based procedures for lead revision making the preservation of intracerebral trajectories possible.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00701-021-04807-1","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:09:51Z","timestamp":1616458191000},"page":"1873-1878","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Frameless x-ray-based lead re-implantation after partial hardware removal of deep brain stimulation system with preservation of intracerebral trajectories"],"prefix":"10.1007","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0062-7490","authenticated-orcid":false,"given":"Vesna","family":"Malinova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz J.","family":"Jask\u00f3lski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafal","family":"W\u00f3jcik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothee","family":"Mielke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit","family":"Rohde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"4807_CR1","doi-asserted-by":"publisher","first-page":"e105288","DOI":"10.1371\/journal.pone.0105288","volume":"9","author":"S Bjerknes","year":"2014","unstructured":"Bjerknes S, Skogseid IM, Saehle T, Dietrichs E, Toft M (2014) Surgical site infections after deep brain stimulation surgery: frequency, characteristics and management in a 10-year period. 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