The efficacy of stereotactic minimally invasive thrombolysis at different catheter positions in the treatment of small- and medium-volume basal ganglia hemorrhage (SMITDCP I): a randomized, controlled, and blinded endpoint phase 1 trial

Frontiers in Neurology

Neurology

Yifei Liu¹  Xin Huang²  Lai Jiang²  Shaojun Chen²  Ziwei Yan³ 

[1] Department of Anesthesiology, The People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei, China;Department of Neurosurgery, The People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei, China;Department of Ultrasound Diagnostics, The People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei, China;

关键词: stereotactic;    minimally invasive;    catheter location;    hypertensive cerebral hemorrhage;    small to medium volume basal ganglia hemorrhage;   

DOI  :  10.3389/fneur.2023.1131283

 received in 2022-12-24, accepted in 2023-04-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveThe aim of this study was to evaluate the effects of stereotactic minimally invasive puncture with different catheter placement positions when combined with urokinase thrombolysis for the treatment of small- and medium-volume basal ganglia hemorrhage. Our goal was to identify the best minimally invasive catheter placement position to enhance therapeutic efficacy for patients with cerebral hemorrhage.MethodsThe stereotactic minimally invasive thrombolysis at different catheter positions in the treatment of small- and medium-volume basal ganglia hemorrhage (SMITDCPI) was a randomized, controlled, and endpoint phase 1 trial. We recruited patients with spontaneous ganglia hemorrhage (medium-to-small and medium volume) who were treated in our hospital. All patients received stereotactic, minimally invasive punctures combined with an intracavitary thrombolytic injection of urokinase hematoma. A randomized number table method was used to divide the patients into two groups concerning the location of catheterization: a penetrating hematoma long-axis group and a hematoma center group. The general conditions of the two groups of patients were compared, and the data were analyzed, including the time of catheterization, the dosage of urokinase, the amount of residual hematoma, the hematoma clearance rate, complications, and the National Institute of Health stroke scale (NIHSS) score data at 1 month after surgery.ResultsBetween June 2019 and March 2022, 83 patients were randomly recruited and assigned to the two groups as follows: 42 cases (50.60%) to the penetrating hematoma long-axis group and 41 cases (49.40%) to the hematoma center group. Compared with the hematoma center group, the long-axis group was associated with a significantly shorter catheterization time, a lower urokinase dose, a lower residual hematoma volume, a higher hematoma clearance rate, and fewer complications (P < 0.05). However, there were no significant differences between the two groups in terms of the NIHSS scores when tested 1 month after surgery (P > 0.05).ConclusionStereotactic minimally invasive puncture combined with urokinase for the treatment of small- and medium-volume hemorrhage in the basal ganglia, including catheterization through the long axis of the hematoma, led to significantly better drainage effects and fewer complications. However, there was no significant difference in short-term NIHSS scores between the two types of catheterization.

【 授权许可】

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Copyright © 2023 Huang, Yan, Jiang, Chen and Liu.