Real-time ultrasound-guided endoscopic surgery for putaminal hemorrhage

Sadahiro, Hirokazu; Nomura, Sadahiro; Goto, Hisaharu; Sugimoto, Kazutaka; Inamura, Akinori; Fujiyama, Yuichi; Yamane, Akiko; Oku, Takayuki; Shinoyama, Mizuya; Suzuki, Michiyasu

doi:10.3171/2014.11.jns141508

“…10 Sadahiro et al used ultrasound-guided endoscopic surgery to remove HPH, the average hematoma clearance rate of which was 96 AE 3%. 11 This method can not only display the location of the endoscope in real time but also display the residual hematoma in real time. Lin et al used threedimensional reconstruction CT images combined with neuroendoscopy to locate HICH (HPH), which can accurately and effectively remove intracerebral hematoma.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Gong

¹

,

Ma

²

2019

J Neurol Surg B Skull Base

1

0

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Background Hypertensive intracerebral hemorrhage is one of the most common cerebrovascular diseases with high mortality and high disability rate. The aim of this study was to observe the curative effect of minimally invasive liquefaction and drainage of hypertensive putaminal hemorrhage (HPH) through frontal approach. Methods This study retrospectively reviewed the clinical data of 66 HPH patients who underwent surgery from January 2012 to January 2017 including 35 males and 31 females, aged 51 to 82 years, with an average age of 61.6 ± 7.32 years. All patients were treated in the first people’s hospital of Kunshan. They were divided into two groups: puncture thrombolysis and drainage therapy (PTDT) group and conventional craniotomy (CC) group. Result The pulmonary infection rate in PTDT group was 13.8%, significantly lower than that of 27.7% in CC group (p < 0.05). One year after onset, the modified Rankin scale (mRS) score of surviving patients was evaluated. The mRS score of the PTDT group with 30 to 60 mL of preoperative bleeding was 1.91 ± 0.82, which was significantly better than that of the CC group (2.21 ± 0.83) (p < 0.05). There was no significant difference in mRS score between PTDT group (2.59 ± 0.62) and CC group (2.88 ± 0.87) with preoperative bleeding > 60 mL (p > 0.05). In patients with Glasgow coma scale (GCS) 5 to 8 scores, the mRS of PTDT and CC groups were 2.73 ± 0.72 and 2.94 ± 0.96, respectively (p > 0.05). In patients with GCS 9 to 13 scores, the mRS score of PTDT group was 1.83 ± 0.69, which was significantly better than that of CC group (2.06 ± 0.74) (p < 0.05). Conclusion HPH can be treated effectively through PTDT. PTDT group has lower lung infection rate than CC group. And it can significantly improve the prognosis of patients with preoperative bleeding volume of 30 to 60 mL and preoperative GCS score of 9 to 13.

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“…Burr hole ultrasound through a second burr hole has also been proposed to monitor ICH evacuation progress in real time 9. Although the authors found it to be practical and reported improved evacuation rates, the need for a second burr hole limits its widespread acceptance.…”

Section: Discussionmentioning

confidence: 99%

Republished: Intracavitary ultrasound (ICARUS): a neuroendoscopic adaptation of intravascular ultrasound for intracerebral hemorrhage evacuation

Chartrain

¹

,

Hom

²

,

Bederson

³

et al. 2018

J NeuroIntervent Surg

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Neurosurgeons performing intracerebral hemorrhage evacuation procedures have limited options for monitoring hematoma evacuation and assessing residual hematoma burden intraoperatively. Here, we report the successful neuroendoscopic adaptation of intravascular ultrasound, referred to here as intracavitary ultrasound (ICARUS), in two patients. Pre-evacuation ICARUS demonstrated dense hematomas in both patients. Post-evacuation ICARUS in patient 1 demonstrated significant reduction in clot burden and two focal hyperechoic regions consistent with pockets of hematoma not previously seen with the endoscope or burr hole ultrasound. These areas were directly targeted and resected with the endoscope and suction device. Post-evacuation ICARUS in patient 2 showed significant reduction of hematoma volume without indication of residual blood. ICARUS findings were confirmed on intraoperative DynaCT and postoperative CT 24 hours later. ICARUS is feasibly performed in a hematoma cavity both before and after hematoma aspiration. ICARUS may provide additional information to the operating surgeon and assist in maximizing hematoma removal.

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“…Burr hole ultrasound through a second burr hole has also been proposed to monitor ICH evacuation progress in real time. 9 Although the authors found it to be practical and reported improved evacuation rates, the need for a second burr hole limits its widespread acceptance. conclusions IVUS was feasibly adapted for use during an endoscopic ICH evacuation procedure to assist in identifying residual clot burden.…”

Section: Alternative Imaging Techniquesmentioning

confidence: 99%

Intracavitary ultrasound (ICARUS): a neuroendoscopic adaptation of intravascular ultrasound for intracerebral hemorrhage evacuation

Chartrain

¹

,

Hom

²

,

Bederson

³

et al. 2017

View full text Add to dashboard Cite

Neurosurgeons performing intracerebral hemorrhage evacuation procedures have limited options for monitoring hematoma evacuation and assessing residual hematoma burden intraoperatively. Here, we report the successful neuroendoscopic adaptation of intravascular ultrasound, referred to here as intracavitary ultrasound (ICARUS), in two patients. Pre-evacuation ICARUS demonstrated dense hematomas in both patients. Post-evacuation ICARUS in patient 1 demonstrated significant reduction in clot burden and two focal hyperechoic regions consistent with pockets of hematoma not previously seen with the endoscope or burr hole ultrasound. These areas were directly targeted and resected with the endoscope and suction device. Post-evacuation ICARUS in patient 2 showed significant reduction of hematoma volume without indication of residual blood. ICARUS findings were confirmed on intraoperative DynaCT and postoperative CT 24 hours later. ICARUS is feasibly performed in a hematoma cavity both before and after hematoma aspiration. ICARUS may provide additional information to the operating surgeon and assist in maximizing hematoma removal.

show abstract

Real-time ultrasound-guided endoscopic surgery for putaminal hemorrhage

Abstract: This navigation method was effective in demonstrating both the real-time location of the endoscope and real-time viewing of the residual hematoma. Use of ultrasound guidance minimized the occurrence of brain injury due to hematoma evacuation.

Cited by 20 publications

References 10 publications

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Republished: Intracavitary ultrasound (ICARUS): a neuroendoscopic adaptation of intravascular ultrasound for intracerebral hemorrhage evacuation

Intracavitary ultrasound (ICARUS): a neuroendoscopic adaptation of intravascular ultrasound for intracerebral hemorrhage evacuation

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