MedStar Authors catalog › Details for: Minimally invasive endoscopic hematoma evacuation vs best medical management for spontaneous basal-ganglia intracerebral hemorrhage.
Minimally invasive endoscopic hematoma evacuation vs best medical management for spontaneous basal-ganglia intracerebral hemorrhage. Journal: Journal of neurointerventional surgery.Published: ; ; 2019ISSN: 1759-8478.UI/PMID: 30617144.Subject(s): Adult | Aged | *Basal Ganglia Hemorrhage/dg [Diagnostic Imaging] | Basal Ganglia Hemorrhage/mo [Mortality] | *Basal Ganglia Hemorrhage/th [Therapy] | Case-Control Studies | Cohort Studies | *Disease Management | Female | Hospital Mortality/td [Trends] | Humans | Male | Middle Aged | *Minimally Invasive Surgical Procedures/mt [Methods] | Minimally Invasive Surgical Procedures/mo [Mortality] | Minimally Invasive Surgical Procedures/st [Standards] | *Neuroendoscopy/mt [Methods] | Neuroendoscopy/mo [Mortality] | Neuroendoscopy/st [Standards] | Pilot Projects | Prospective Studies | Retrospective Studies | Treatment OutcomeInstitution(s): MedStar Washington Hospital CenterDepartment(s): Surgery/Surgical Critical CareActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1136/neurintsurg-2018-014447 (Click here) Abbreviated citation: J Neurointerv Surg. 11(6):579-583, 2019 Jun.Local Holdings: Available online through MWHC library: 2009 - present.Abstract: BACKGROUND: We conducted a case-control study to assess the relative safety and efficacy of minimally invasive endoscopic surgery (MIS) for clot evacuation in patients with basal-ganglia intracerebral hemorrhage (ICH).Abstract: METHODS: We evaluated consecutive patients with acute basal-ganglia ICH at a single center over a 42-month period. Patients received either best medical management according to established guidelines (controls) or MIS (cases). The following outcomes were compared before and after propensity-score matching (PSM): in-hospital mortality; discharge National Institutes of Health Stroke Scale score; discharge disposition; and modified Rankin Scale scores at discharge and at 3 months.Abstract: RESULTS: Among 224 ICH patients, 19 (8.5%) underwent MIS (mean age, 50.9+/-10.9; 26.3% female, median ICH volume, 40 (IQR, 25- 51)). The interventional cohort was younger with higher ICH volume and stroke severity compared with the medically managed cohort. After PSM, 18 MIS patients were matched to 54 medically managed individuals. The two cohorts did not differ in any of the baseline characteristics. The median ICH volume at 24 hours was lower in the intervention group (40 cm<sup>3</sup> (IQR, 25-50) vs 15 cm<sup>3</sup> (IQR, 5-20); P<0.001). The two cohorts did not differ in any of the pre-specified outcomes measures except for in-hospital mortality, which was lower in the interventional cohort (28% vs 56%; P=0.041).Abstract: CONCLUSIONS: Minimally invasive endoscopic hematoma evacuation was associated with lower rates of in-hospital mortality in patients with spontaneous basal-ganglia ICH. These findings support a randomized controlled trial of MIS versus medical management for ICH.Abstract: Copyright (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.