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Zhao YN, Chen XL. Endoscopic treatment of hypertensive intracerebral hemorrhage: A technical review. Chronic Dis Transl Med 2016; 2:140-146. [PMID: 29063035 PMCID: PMC5643758 DOI: 10.1016/j.cdtm.2016.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Indexed: 01/07/2023] Open
Abstract
Hypertensive intracerebral hemorrhage (ICH) is still a highlighting global issue. Endoscopic evacuation as a minimally invasive treatment became an alternative other than conventional craniotomy and catheter drainage for ICH. However, there is no unified indication or standardized procedure on endoscopic treatment of ICH. Here we explored the literature and gathered information from different studies, to review the background, technical points, and existing problems of endoscopic treatment for ICH.
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Affiliation(s)
| | - Xiao-lei Chen
- Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Yang Z, Hong B, Jia Z, Chen J, Ge J, Han J, Beilner J, Zhang Y, Fang Y, Liu J. Treatment of supratentorial spontaneous intracerebral hemorrhage using image-guided minimally invasive surgery: Initial experiences of a flat detector CT-based puncture planning and navigation system in the angiographic suite. AJNR Am J Neuroradiol 2014; 35:2170-5. [PMID: 24994826 DOI: 10.3174/ajnr.a4009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE The intracerebral hemorrhage drainage through minimally invasive approach is emerging as an alternative for traditional craniotomy, due to its improved survival rate and reduced complication rate. In this study, we investigated the feasibility and safety of a flat detector CT-based puncture planning and navigation system for minimally invasive hematoma drainage on patients with intracerebral hemorrhage. MATERIALS AND METHODS The minimally invasive hematoma drainage was performed on 21 hypertensive patients with intracerebral hemorrhage in the angiographic suite with the guidance of a flat detector CT-based puncture planning and navigation system. This system is integrated in the angiographic machine, and was used for 1) planning the needle path based on a preprocedural flat detector CT scan, 2) advancing the catheter with real-time fluoroscopic guidance, and 3) confirming the procedure outcome based on an immediate postprocedural flat detector CT. The surgery efficiency, accuracy, and the treatment outcome were measured and compared with the published data. RESULTS All procedures were successfully completed with the catheter placed 4 ± 1 mm from the planned position. The average surgery time was 40 ± 7 minutes. The volume of the hematoma was reduced to 28 ± 4% of the original volume. The Glasgow Coma Scale score was significantly improved from 10 ± 1 at the admission to 14 ± 1 at the discharge. The Extended Glasgow Coma Scale score also improved from 5 ± 1 at the discharge to 6 ± 1 at the 6-month follow-up. No major complication, rebleeding, and mortality were observed in this study. CONCLUSIONS This flat detector CT-based needle guidance system provided a feasible, convenient, and safe way to perform the puncture and drainage of brain hematoma in the angiographic suite.
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Affiliation(s)
- Z Yang
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
| | - B Hong
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Z Jia
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
| | - J Chen
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
| | - J Ge
- Siemens Ltd. China (J.G., J.H., J.B.), Healthcare Sector, Angiography & Interventional X-Ray Systems, Shanghai, China
| | - J Han
- Siemens Ltd. China (J.G., J.H., J.B.), Healthcare Sector, Angiography & Interventional X-Ray Systems, Shanghai, China
| | - J Beilner
- Siemens Ltd. China (J.G., J.H., J.B.), Healthcare Sector, Angiography & Interventional X-Ray Systems, Shanghai, China
| | - Y Zhang
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Y Fang
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
| | - J Liu
- From the Department of Neurosurgery (Z.Y., B.H., Z.J., J.C., Y.Z., Y.F., J.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
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