Postoperative Reduction of Intraventricular Hemorrhage Volume: Single- Versus Dual-Catheter Drainage

Hussain, Syed Shahzad; Raza, Asif; Shahid, Saman; Asif, Hafiz Hamza; Ahmad, Usman; Ashraf, Naveed

doi:10.1055/s-0037-1617757

Cited by 6 publications

(3 citation statements)

References 32 publications

(41 reference statements)

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“…It is well established that a large volume of IVH is strongly associated with poor neurological outcomes 34,35 .…”

Section: Discussionmentioning

confidence: 99%

The combination of conventional EVD and Ommaya drainage for intraventricular hemorrhage (IVH)

Zhu

Zang

et al. 2023

Preprint

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Background: The effect of Ommaya reservoirs on the clinical outcomes of patients with intraventricular hemorrhage (IVH) remains unclear. Objective: To determine the effect of combining the Ommaya reservoir and external ventricular drainage (EVD) therapy on IVH and to explore better clinical indicators for Ommaya implantation. Methods: A retrospective analysis was conducted on patients diagnosed with IVH who received EVD-Ommaya drainage between January 2013 and March 2021. The patient population was divided into two groups: the Ommaya-used group, comprising of patients in whom the Ommaya drainage system was activated post-surgery, and the Ommaya-unused group, comprising of patients in whom the system was not activated. The study analyzed clinical, imaging, and outcome data of the patient population. Results: A total of 123 patients with IVH were included: 75 patients in the Ommaya-used group and 48 patients in the Ommaya-unused group. The patients in the Ommaya-used group showed a lower 3-month GOS than those in the Ommaya-unused group (p<0.0001). The modified Graeb scale (mGS) in the Ommaya-unused group was significantly lower than that in the Ommaya-used group before the operation (p<0.01) but not after surgery (p>0.05). The GCS in the Ommaya-unused group was significantly lower than the other group, and there was a close correlation between the GCS and 3-month GOS (p<0.0001). The GCS score showed significance in predicting the use of Ommaya (p<0.001). Conclusions: The study demonstrated that combining EVD and Ommaya drainage was an effective treatment for IVH. Additionally, preoperative GCS was found to predict the use of Ommaya drainage in subsequent treatment, providing valuable information for pre-surgery decision-making.

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“…It is well established that a large volume of IVH is strongly associated with poor neurological outcomes 34,35 .…”

Section: Discussionmentioning

confidence: 99%

The combination of conventional EVD and Ommaya drainage for intraventricular hemorrhage (IVH)

Zhu

Zang

et al. 2023

Preprint

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“…Although there are no comparable reports according to the number of inserted catheters in surgery for sICH that were similar to our study, several reports related to EVD were found. In cases of intraventricular hemorrhage (IVH), there have been several studies comparing the efficacy of single catheters and dual catheters [ 36 , 37 ]. Dual catheters may be useful in the management of very large-volume IVH.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Outcomes Following Neuronavigation-Assisted Aspiration and Thrombolysis Using Single and Multiple Catheter Insertion for Moderate-Volume Supratentorial Spontaneous Intracerebral Hemorrhage: A Single-Center Retrospective Study of 102 Patients

Lee

Choi

2021

Med Sci Monit

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Background This retrospective study from a single center aimed to investigate 102 patients with isolated moderate-volume (30–60 mL) supratentorial spontaneous intracerebral hemorrhage (sICH) treated with neuronavigation-assisted aspiration and thrombolysis to compare outcomes using single and multiple catheter insertion. Material/Methods We retrospectively enrolled 102 patients (58 single-catheter insertion recipients and 44 multi-catheter insertion recipients) diagnosed with isolated moderate-volume supratentorial sICH who underwent neuronavigation-assisted aspiration and thrombolysis surgery in a single center between March 2017 and December 2019. The impact of multi-catheter insertion on the radiologic and clinical outcomes and complications were compared with those of single-catheter insertion. Results The baseline characteristics, clinical status, and outcomes of both groups were not significantly different, except for the number of inserted catheters and surgical time. The single-catheter group had a significantly shorter surgical time than the multi-catheter group (39.52±8.76 min vs 61.39±16.6 min; P <0.001). The surgery-related complication catheter tract hemorrhage (CTH) occurred significantly more frequently in the multi-catheter group than in the single-catheter group (8.6% vs 27.3%; P =0.019). In the regression analysis, international normalized ratio prolongation and multi-catheter insertion were independent risk factors for CTH. Conclusions Single-catheter insertion is not inferior to multi-catheter insertion for isolated moderate-volume (30–60 mL) supratentorial sICH in terms of radiologic and clinical outcomes and significantly shortened the surgical time and reduced the incidence of CTH.

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“…Clot volumes ranged from 10 ml -50 ml [9,5,12,4,11]. In this study, 1.6 ml of 0.25 M calcium chloride was added to 20 ml of blood drawn from healthy donors (aged between 20 to 30 years) to reverse the intrinsic anticoagulation cascade [27].…”

Section: Clot Preparationmentioning

confidence: 99%

Recirculatory Fibrinolytic-Assisted External Ventricular Drainage (EVD) for Intraventricular Hemorrhage

Qin¹,

Kwok

Woo

et al. 2021

Preprint

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Background Elevated intracranial pressure and acute obstructive hydrocephalus secondary to intraventricular hemorrhage (IVH) can be treated by external ventricular drainage (EVD). The treatment time and the risk of EVD-related complications can be reduced with fibrinolytic agents’ instillation via an EVD catheter, but previous clinical trial results did not reveal a significant improvement in terms of long-term functional outcomes. A recirculatory fibrinolytic-assisted EVD system was designed. The clot dissolution effectiveness of the system under different drug dosages and fluid flow rates was tested in an ex vivo model. Results The results showed that the mean clot mass was quickly reduced in an initial fibrinolytic agent dose-independent stage, followed by a dose-dependent stage. Elevating fibrinolytic agent dosages beyond a certain threshold did not contribute to shorter dissolution times. Optimal treatment parameters for such a system were determined. A recirculatory flow rate of 10–18 ml/min with a low-dose of 30 000–60 000 IU of uPA resulted in an 80% clot mass reduction within four hours. Conclusions This recirculating fibrinolytic system is a promising novel modification of conventional IVH treatment that could reduce clot dissolution times and procedure-related complications.

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Postoperative Reduction of Intraventricular Hemorrhage Volume: Single- Versus Dual-Catheter Drainage

Cited by 6 publications

References 32 publications

The combination of conventional EVD and Ommaya drainage for intraventricular hemorrhage (IVH)

The combination of conventional EVD and Ommaya drainage for intraventricular hemorrhage (IVH)

Comparison of Outcomes Following Neuronavigation-Assisted Aspiration and Thrombolysis Using Single and Multiple Catheter Insertion for Moderate-Volume Supratentorial Spontaneous Intracerebral Hemorrhage: A Single-Center Retrospective Study of 102 Patients

Recirculatory Fibrinolytic-Assisted External Ventricular Drainage (EVD) for Intraventricular Hemorrhage

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