A second trial of a clot evacuation approach to remove a hematoma in spontaneous ICH has shown some encouraging results, despite a neutral primary endpoint.
A new trial of a minimally invasive surgical approach to removing the hematoma in patients with spontaneous intracerebral hemorrhage has shown some encouraging results, despite a neutral primary endpoint.
Fiorella explained that spontaneous ICH is a relatively common experience, with around 80,000 cases per year in the United States. Blood leakage from a ruptured cerebral blood vessel into the brain parenchyma causes brain injury, and these patients have a mortality rate of 30%-40%. There is a large unmet need in this field, and despite considerable health and economic burden, the majority of patients with ICH are left without any definitive treatment, he said.
The MIND trial planned to include 500 patients with moderate to large volume supratentorial ICH , presenting within 24 hours of symptom onset, who were randomized to the minimally invasive surgical procedure or best medical therapy alone within 72 hours of the bleed. Fiorella noted that the procedure showed excellent rates of hematoma evacuation of around 80% in both patents with deep and lobar ICH and was quick to perform with an average procedure time of 27 minutes . The rate of conversion to craniotomy was very low at 1.4%.
However, there was a numerical, but not significant, reduction in mortality with the surgical approach in patients with lobar ICH — 22.7% medical vs 8.3% minimally invasive surgery. He also suggested that better results may have been obtained if the procedure had been conducted earlier.
Cerebrovascular Accident CVA Cerebrovascular Accident (CVA) Surgery Hemorrhage Bleeding Brain Traumatic Brain Injury TBI Traumatic Brain Injury (TBI) Wound Management Wound Care Blood Vessels Blood Disability Hospitals Injury
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