单位:[1]Icahn Sch Med Mt Sinai, Dept Neurosurg, New York, NY 10029 USA[2]Med Univ South Carolina, Dept Neurosurg, Charleston, SC 29425 USA[3]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Dept Neurol,Wuhan,Hubei,Peoples R China神经内科华中科技大学同济医学院附属同济医院神经科[4]Beijing Neurosurg Inst, Beijing, Peoples R China首都医科大学附属天坛医院[5]Capital Med Univ, Tiantan Hosp, Beijing, Peoples R China首都医科大学附属天坛医院[6]Emory Univ, Sch Med, Dept Neurol Surg, Atlanta, GA USA[7]Jikei Univ, Sch Med, Dept Neurosurg, Tokyo, Japan
BACKGROUND: Minimally invasive intracerebral hemorrhage (ICH) evacuation has gained popularitywith success in early-phase clinical trials. This procedure, however, is performed in very different ways around the world. OBJECTIVE: To provide a technical description of these strategies that facilitates comparison and aids decisions in which surgery to perform, and to inform further improvements in minimally invasive ICH evacuation. METHODS: Major authors of clinical trials evaluating each of the main techniques were contacted and asked to supply a case example and technical description of their respective surgeries. RESULTS: Five major techniques are presented including stereotactic thrombolysis, craniopuncture, endoscopic, endoscope-assisted, and endoport-mediated. Techniques differ in numerous ways including the size of the cranial access, the size of the access corridor through the brain to the hematoma, and the evacuation strategy. Regarding cranial access, a burr hole is created in stereotactic thrombolysis and craniopuncture, a small craniectomy in endoscopic, and a small craniotomy in the other 2. Access corridors through the parenchyma range from3mmin craniopuncture to 13.5mmin the endoportmediated evacuation. Regarding evacuation strategies, stereotactic thrombolysis and craniopuncture rely on passive drainage from a catheter placed during surgery that remains in place for multiple days, while the other 3 techniques rely on active evacuation with suction and bipolar cautery. CONCLUSION: Future comparative clinical trials may identify the advantageous components of each strategy and contribute to improved outcomes in this patient population.
第一作者单位:[1]Icahn Sch Med Mt Sinai, Dept Neurosurg, New York, NY 10029 USA
通讯作者:
通讯机构:[2]Med Univ South Carolina, Dept Neurosurg, Charleston, SC 29425 USA[*1]Intracerebral Hemorrhage Program, Dept Neurosurg, 1468 Madison Ave,Annenberg 8th Floor, New York, NY 10029 USA
推荐引用方式(GB/T 7714):
Pan Jonathan,Chartrain Alexander G.,Scaggiante Jacopo,et al.A Compendium of Modern Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques[J].OPERATIVE NEUROSURGERY.2020,18(6):710-720.doi:10.1093/ons/opz308.
APA:
Pan, Jonathan,Chartrain, Alexander G.,Scaggiante, Jacopo,Spiotta, Alejandro M.,Tang, Zhouping...&Kellner, Christopher P..(2020).A Compendium of Modern Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques.OPERATIVE NEUROSURGERY,18,(6)
MLA:
Pan, Jonathan,et al."A Compendium of Modern Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques".OPERATIVE NEUROSURGERY 18..6(2020):710-720