Intraventricular hemorrhage treated with intraventricular fibrinolysis. A 10-year experience

Ávila, S. Castaño; Lozano, E. Corral; Cueva, Acevedo; Moliner, Javier; López, Ana M.; Miguel, F. Fonseca San; Matos, J.A. Urturi; Ramírez, A. Manzano

doi:10.1016/j.medine.2012.02.012

Cited by 1 publication

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“…Although external ventricular drainage (EVD) without thrombolytic agents is firstly used to help drain blood from the ventricles, using EVD alone may not effectively improve the patients’ outcome because of the slow rate of removing intraventricular blood [ 7 ]. With increasing clinical studies reporting that intraventricular administration of thrombolytic agents may reduce mortality by accelerating clot lysis [ 8 – 10 ], there has been more interest in using thrombolytic agents as adjuncts to EVD in the setting of IVH. A meta-analysis of 8 observational and 4 randomized studies of patients with IVH treated with EVD ( n = 149) or EVD with fibrinolysis ( n = 167) found a significant decrease in mortality from 47 to 23% (OR, 0.32; 95% CI, 0.19–0.52) [ 11 ].…”

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confidence: 99%

Endoscopic intraventricular hematoma evacuation surgery versus external ventricular drainage for the treatment of patients with moderate to severe intraventricular hemorrhage: a multicenter, randomized, controlled trial

Zhu

Tang

Cong

et al. 2020

Trials

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Background: The application of neuroendoscopy in intraventricular hemorrhage (IVH) has attracted more and more attention in recent years. Studies have shown that the use of neuroendoscopy for IVH evacuation has advantages over external ventricular drainage (EVD) alone. However, the cases of most current research are small and all of them are retrospective studies. The aim of this study is to explore the prognosis of patients with moderate to severe IVH who undergo endoscopic IVH evacuation surgery versus those who undergo EVD alone. Methods: The study is a prospective, randomized, controlled, multi-center clinical trial. Nine hundred and fifty-six subjects with moderate to severe IVH across four tertiary hospitals in China will be randomly assigned (1:1) to receive either endoscopic IVH evacuation surgery or EVD. The primary objective is to compare patients' survival rate at 12 months after surgery. Discussion: The trial is designed to investigate the prognostic benefits of endoscopic IVH evacuation surgery for patients with moderate to severe IVH. Currently, it has never been investigated in a prospective randomized controlled clinical trial.

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