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A Compendium of Modern Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques

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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 [4]Beijing Neurosurg Inst, Beijing, Peoples R China [5]Capital Med Univ, Tiantan Hosp, Beijing, Peoples R China [6]Emory Univ, Sch Med, Dept Neurol Surg, Atlanta, GA USA [7]Jikei Univ, Sch Med, Dept Neurosurg, Tokyo, Japan
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关键词: Intracerebral hemorrhage Hemorrhagic stroke Minimally invasive surgery

摘要:
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.

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2018]版:
Q3 SURGERY Q4 CLINICAL NEUROLOGY
最新[2024]版:
Q3 SURGERY Q4 CLINICAL NEUROLOGY

影响因子: 最新[2024版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Icahn Sch Med Mt Sinai, Dept Neurosurg, New York, NY 10029 USA
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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
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