ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for Brain Hemorrhage: A Multicenter Randomized Controlled Trial.

Abstract:

BACKGROUND AND PURPOSE:Intracerebral hemorrhage (ICH) is a devastating disease without a proven therapy to improve long-term outcome. Considerable controversy about the role of surgery remains. Minimally invasive endoscopic surgery for ICH offers the potential of improved neurological outcome. METHODS:We tested the hypothesis that intraoperative computerized tomographic image-guided endoscopic surgery is safe and effectively removes the majority of the hematoma rapidly. A prospective randomized controlled study was performed on 20 subjects (14 surgical and 4 medical) with primary ICH of >20 mL volume within 48 hours of ICH onset. We prospectively used a contemporaneous medical control cohort (n=36) from the MISTIE trial (Minimally Invasive Surgery and r-tPA for ICH Evacuation). We evaluated surgical safety and neurological outcomes at 6 months and 1 year. RESULTS:The intraoperative computerized tomographic image-guided endoscopic surgery procedure resulted in immediate reduction of hemorrhagic volume by 68±21.6% (interquartile range 59-84.5) within 29 hours of hemorrhage onset. Surgery was successfully completed in all cases, with a mean operative time of 1.9 hours (interquartile range 1.5-2.2 hours). One surgically related bleed occurred peri-operatively, but no patient met surgical safety stopping threshold end points for intraoperative hemorrhage, infection, or death. The surgical intervention group had a greater percentage of patients with good neurological outcome (modified Rankin scale score 0-3) at 180 and 365 days as compared with medical control subjects (42.9% versus 23.7%; P=0.19). CONCLUSIONS:Early computerized tomographic image-guided endoscopic surgery is a safe and effective method to remove acute intracerebral hematomas, with a potential to enhance neurological recovery. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT00224770.

journal_name

Stroke

journal_title

Stroke

authors

Vespa P,Hanley D,Betz J,Hoffer A,Engh J,Carter R,Nakaji P,Ogilvy C,Jallo J,Selman W,Bistran-Hall A,Lane K,McBee N,Saver J,Thompson RE,Martin N,ICES Investigators.

doi

10.1161/STROKEAHA.116.013837

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

2749-2755

issue

11

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.116.013837

journal_volume

47

pub_type

杂志文章,多中心研究,随机对照试验

相关文献

STROKE文献大全
  • Clinical outcomes of carotid endarterectomy in patients with carotid artery tandem lesions.

    abstract:BACKGROUND AND PURPOSE:When carotid artery tandem lesions are present, the benefits of carotid endarterectomy (CEA) to reduce recurrent stroke remain uncertain. The present retrospective cohort study aimed to determine the clinical outcomes of CEA for carotid artery tandem stenosis that was diagnosed by contrast-enhanc...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.007181

    authors: Han Y,Park H,Kwon SU,Kang DW,Lee DH,Kwon H,Kwon TW,Cho YP,Kim GE

    更新日期:2014-11-01 00:00:00

  • Leukoaraiosis and dementia in hypertensive patients.

    abstract:BACKGROUND AND PURPOSE:Although our previous study demonstrated that dementia of the Binswanger type may be a disconnection dementia caused by leukoaraiosis, some hypertensive patients with marked leukoaraiosis do not develop dementia. The goal of the present study is to elucidate the pathophysiology of nondemented hyp...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.11.1673

    authors: Yao H,Sadoshima S,Ibayashi S,Kuwabara Y,Ichiya Y,Fujishima M

    更新日期:1992-11-01 00:00:00

  • Prospective study of depressive symptoms and risk of stroke among japanese.

    abstract:BACKGROUND AND PURPOSE:We sought to examine the relationship between depressive symptoms and the incidence of stroke among Japanese men and women. METHODS:A 10.3-year prospective study on the relationship between depressive symptoms and the incidence of stroke was conducted with 901 men and women aged 40 to 78 years i...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.32.4.903

    authors: Ohira T,Iso H,Satoh S,Sankai T,Tanigawa T,Ogawa Y,Imano H,Sato S,Kitamura A,Shimamoto T

    更新日期:2001-04-01 00:00:00

  • Reduced vitamin D in acute stroke.

    abstract:BACKGROUND AND PURPOSE:Stroke leads to a reduction in bone mineral density, altered calcium homeostasis, and an increase in hip fractures. Vitamin D deficiency is well documented in long-term stroke survivors and is associated with post-stroke hip fractures. Less is known regarding levels in acute stroke. METHODS:We c...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000195184.24297.c1

    authors: Poole KE,Loveridge N,Barker PJ,Halsall DJ,Rose C,Reeve J,Warburton EA

    更新日期:2006-01-01 00:00:00

  • Platelet accumulation in regions of low blood flow during the postischemic period.

    abstract::Various studies indicate that after a latent interval, a progressive focal deterioration of microvascular perfusion can develop in zones of acute damage to the central nervous system (CNS). In order to obtain reliable information concerning the possibility of platelet participation in this phenomenon, platelet deposit...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.16.2.224

    authors: Obrenovitch TP,Hallenbeck JM

    更新日期:1985-03-01 00:00:00

  • Polymorphisms of coagulation factor XIII subunit A and risk of nonfatal hemorrhagic stroke in young white women.

    abstract:BACKGROUND AND PURPOSE:Although family studies have suggested a genetic influence on hemorrhagic stroke, the underlying genetic risk factors remain poorly defined. Coagulation factor XIII, which is involved in hemostasis, fibrinolysis, vascular remodeling, and tissue repair, represents a candidate gene for hemorrhagic ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/hs1101.098150

    authors: Reiner AP,Schwartz SM,Frank MB,Longstreth WT Jr,Hindorff LA,Teramura G,Rosendaal FR,Gaur LK,Psaty BM,Siscovick DS

    更新日期:2001-11-01 00:00:00

  • Breathing 100% oxygen after global brain ischemia in Mongolian Gerbils results in increased lipid peroxidation and increased mortality.

    abstract::Exposure of Mongolian gerbils to a 100% oxygen atmosphere after 15 minutes of global brain ischemia resulted in a marked increase in the production of pentane, an in vivo product of lipid peroxidation. Much less pentane production occurred in animals subjected to global brain ischemia then exposed to an air atmosphere...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.2.426

    authors: Mickel HS,Vaishnav YN,Kempski O,von Lubitz D,Weiss JF,Feuerstein G

    更新日期:1987-03-01 00:00:00

  • Impact of chronic kidney disease on carotid atherosclerosis according to blood pressure category: the Suita study.

    abstract:BACKGROUND AND PURPOSE:We aimed to clarify the association of chronic kidney disease (CKD) with carotid atherosclerosis and the impact of CKD on carotid atherosclerosis according to blood pressure categories in an urban general population. METHODS:We studied 3466 Japanese individuals (35-93 years old) in the Suita Stu...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.002957

    authors: Ohara T,Kokubo Y,Toyoda K,Watanabe M,Koga M,Nakamura S,Nagatsuka K,Minematsu K,Nakagawa M,Miyamoto Y

    更新日期:2013-12-01 00:00:00

  • Mechanism of ATP-induced [Ca(2+)](i) mobilization in rat basilar smooth muscle cells.

    abstract:BACKGROUND AND PURPOSE:We have previously reported that extracellular ATP activates P(2u) receptors and increases intracellular free Ca(2+) ([Ca(2+)](i)) by G protein/phospholipase C/inositol 1,4,5-triphosphate pathways in cerebral artery smooth muscle cells. However, the possible contribution of other signaling pathwa...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.31.6.1377

    authors: Aoki K,Zubkov AY,Parent AD,Zhang JH

    更新日期:2000-06-01 00:00:00

  • Influence of anesthetics on metabolic, functional and pathological responses to regional cerebral ischemia.

    abstract::Regional cerebral ischemia was produced by common carotid artery occlusion in gerbils and by middle cerebral artery occlusion in dogs, cats, and squirrel monkeys. Anesthesia was induced with either pentobarbital or halothane and maintained for two to three hours after vessel occlusion. In acute studies, the effect of ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.6.4.405

    authors: Michenfelder JD,Milde JH

    更新日期:1975-07-01 00:00:00

  • Cerebral hemorrhage in neonates with coarctation of the aorta.

    abstract::Coarctation of the aorta is an uncommon cause of cerebral hemorrhage in the full- or near-term infant. The clinical, radiologic, and neurologic findings of four infants with aortic coarctation and cerebral hemorrhage are presented. In all four infants, cerebral hemorrhage was associated with only moderate elevation of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.13.4.491

    authors: Young RS,Liberthson RR,Zalneraitis EL

    更新日期:1982-07-01 00:00:00

  • Subcortical hypoperfusion associated with asymptomatic white matter lesions on magnetic resonance imaging.

    abstract:BACKGROUND AND PURPOSE:We examined whether hemodynamic and metabolic abnormalities in the cerebral white matter, basal ganglia, and thalamus are associated with asymptomatic white matter lesions (WML) depicted on MR images. METHODS:A positron emission tomographic study with H2(15)O, C15O, and 15O2 was performed in eig...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.10.1944

    authors: Hatazawa J,Shimosegawa E,Satoh T,Toyoshima H,Okudera T

    更新日期:1997-10-01 00:00:00

  • Marked Regional Variation in Acute Stroke Treatment Among Medicare Beneficiaries.

    abstract:BACKGROUND AND PURPOSE:Little is known about how regions vary in their use of thrombolysis (intravenous tissue-type plasminogen activator and intra-arterial treatment) for acute stroke. We sought to determine regional variation in thrombolysis treatment and investigate the extent to which regional variation is accounte...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.115.009163

    authors: Skolarus LE,Meurer WJ,Shanmugasundaram K,Adelman EE,Scott PA,Burke JF

    更新日期:2015-07-01 00:00:00

  • In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up.

    abstract:BACKGROUND AND PURPOSE:The Stroke PROTECT (Preventing Recurrence Of Thromboembolic Events through Coordinated Treatment) program systematically implements, at the time of acute transient ischemic attack (TIA) or ischemic stroke admission, 8 medication/behavioral secondary prevention measures known to improve outcome in...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000147967.49567.d6

    authors: Ovbiagele B,Saver JL,Fredieu A,Suzuki S,Selco S,Rajajee V,McNair N,Razinia T,Kidwell CS

    更新日期:2004-12-01 00:00:00

  • Transforming growth factor-beta mediates astrocyte-specific regulation of brain endothelial anticoagulant factors.

    abstract:BACKGROUND AND PURPOSE:Astrocytes are potent regulators of brain capillary endothelial cell function. Recently, astrocytes were shown to regulate brain capillary endothelial expression of the fibrinolytic enzyme tissue plasminogen activator (tPA) and the anticoagulant thrombomodulin (TM). To study the mechanism of this...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.30.8.1671

    authors: Tran ND,Correale J,Schreiber SS,Fisher M

    更新日期:1999-08-01 00:00:00

  • Leukocyte rheology in recent stroke.

    abstract::Eighteen patients with recent ischemic stroke were compared with an equal number of matched controls. Standardized suspensions of red cells as well as of red and white cells were filtered in a new filtration apparatus capable of discriminating between cell deformability and filter occlusion. Results show that red cell...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.1.59

    authors: Ernst E,Matrai A,Paulsen F

    更新日期:1987-01-01 00:00:00

  • Incremental predictive value of carotid inflammation in acute ischemic stroke.

    abstract:BACKGROUND AND PURPOSE:Microwave Radiometry (MWR) allows in vivo noninvasive assessment of internal temperature of tissues. The aim of the present study was to evaluate in patients with ischemic stroke and bilateral carotid plaques (1) whether ipsilateral carotid arteries exhibit higher temperature differences (ΔT), as...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.007526

    authors: Toutouzas K,Benetos G,Drakopoulou M,Deligianni C,Spengos K,Stefanadis C,Siores E,Tousoulis D

    更新日期:2015-01-01 00:00:00

  • Effects of hypothermia on evoked potentials, magnetic resonance imaging, and blood flow in focal ischemia in rabbits.

    abstract:BACKGROUND AND PURPOSE:Mild hypothermia has been shown to ameliorate neuronal damage due to cerebral ischemia. In our study, the influence of mild-to-moderate hypothermia was examined in a rabbit model of focal cerebral ischemia. METHODS:After 4 hours of permanent ischemia induced by occlusion of the anterior and midd...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.6.889

    authors: Lo EH,Steinberg GK

    更新日期:1992-06-01 00:00:00

  • An epidemiological survey of stroke in Lhasa, Tibet, China.

    abstract:BACKGROUND AND PURPOSE:There have not been any new epidemiological studies related to stroke in Tibet for 20 years. This study aimed to collect stroke data from The City Staff Medical Insurance Registry in Lhasa, Tibet, to describe the incidence, clinical subtypes, and associated risk factors of stroke. METHODS:We use...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.586669

    authors: Zhao Y,Yao Z,D'Souza W,Zhu C,Chun H,Zhuoga C,Zhang Q,Hu X,Zhou D

    更新日期:2010-12-01 00:00:00

  • Use of a decibel threshold in detecting Doppler embolic signals.

    abstract:BACKGROUND AND PURPOSE:To improve reproducibility and reliability in the identification of embolic signals detected with the use of Doppler ultrasound, many studies have used an intensity threshold. However, variable thresholds between 3 and 12 dB have been used, and often the method of measurement of intensity is not ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.4.692

    authors: Markus HS,Molloy J

    更新日期:1997-04-01 00:00:00

  • Sympathetic nerve activity: a link to stroke?

    abstract::Spontaneously hypertensive rats (SHR) have been shown to have an increased capacity for superior cervical sympathetic nerve activity which may protect against stroke (Mueller et al: Stroke 13: 115, 1982). Sympathetic nerve activity has never been examined in the stroke-prone substrain of SHR (SP). In this study we mea...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.16.1.73

    authors: Mueller SM,Black WL Jr

    更新日期:1985-01-01 00:00:00

  • Alteration of intracellular metabolite diffusion in rat brain in vivo during ischemia and reperfusion.

    abstract:BACKGROUND AND PURPOSE:Diffusion-weighted MRI can demonstrate decreases of the apparent diffusion coefficient (ADC) of brain tissue water shortly after the onset of ischemia. To further elucidate underlying mechanisms, this study extended diffusion assessment to intracellular metabolites in rat brain in vivo before, du...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.10.1930

    authors: Wick M,Nagatomo Y,Prielmeier F,Frahm J

    更新日期:1995-10-01 00:00:00

  • Biphasic striatal dopamine release during transient ischemia and reperfusion in gerbils.

    abstract::To clarify the nature of ischemic striatal dopamine release during the earliest periods of neuronal injury, we used chronoamperometry to measure dopamine levels every 60 seconds during various durations of ischemia in 32 gerbils. Catecholamine-selective electrodes were implanted into the brains of anesthetized gerbils...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.22.5.674

    authors: Ahn SS,Blaha CD,Alkire MT,Wood E,Gray-Allan P,Marrocco RT,Moore WS

    更新日期:1991-05-01 00:00:00

  • Early NT-ProBNP (N-Terminal Probrain Natriuretic Peptide) Elevation Predicts Malignant Edema and Death After Reperfusion Therapy in Acute Ischemic Stroke Patients.

    abstract:BACKGROUND AND PURPOSE:We aimed to investigate the relationship between early NT-proBNP (N-terminal probrain natriuretic peptide) and all-cause death in patients receiving reperfusion therapy, including intravenous thrombolysis and endovascular thrombectomy (EVT). METHODS:This study included 1039 acute ischemic stroke...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.029593

    authors: Zhang X,Yan S,Zhong W,Yu Y,Lou M

    更新日期:2021-01-01 00:00:00

  • Effect of thrombin inhibition in vascular dementia and silent cerebrovascular disease. An MR spectroscopy study.

    abstract:BACKGROUND AND PURPOSE:Silent cerebrovascular disease (CVD) has been proposed as a predisposing condition for clinically overt stroke and vascular dementia. Recently, we found increased thrombin generation in silent CVD patients. Here, we report the effect of thrombin inhibition using a potent selective thrombin inhibi...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.str.30.5.1033

    authors: Kario K,Matsuo T,Hoshide S,Umeda Y,Shimada K

    更新日期:1999-05-01 00:00:00

  • Stroke rehabilitation outcome: impact of coronary artery disease.

    abstract::The frequency of clinically significant coronary artery disease (CAD) among stroke patients and the impact of CAD on stroke rehabilitation were studied in 132 patients with first thrombotic or embolic stroke who participated in comprehensive rehabilitation. Sixty-one patients (46%) had a history of CAD, and 16 of the ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.19.1.42

    authors: Roth EJ,Mueller K,Green D

    更新日期:1988-01-01 00:00:00

  • Sex-specific role of thioredoxin in neuroprotection against iron-induced brain injury conferred by estradiol.

    abstract:BACKGROUND AND PURPOSE:Accumulation of iron after intracerebral hemorrhage causes free radical formation and oxidative damage resulting in liquefaction. The aim of this study was the investigation of molecular mechanisms underlying estrogen-mediated neuroprotective effect against iron-induced brain injury in vivo. MET...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.562850

    authors: Chen TY,Tsai KL,Lee TY,Chiueh CC,Lee WS,Hsu C

    更新日期:2010-01-01 00:00:00

  • Use of the Health Utilities Index with stroke patients and their caregivers.

    abstract:BACKGROUND AND PURPOSE:Few studies currently assess the health-related quality of life of individuals following a stroke. One of the major challenges of assessing quality of life is the high likelihood that after a stroke a patient will not be able to complete such an assessment. One practical solution is to have a fam...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.10.1888

    authors: Mathias SD,Bates MM,Pasta DJ,Cisternas MG,Feeny D,Patrick DL

    更新日期:1997-10-01 00:00:00

  • Age-related vulnerability to cerebral ischemia in spontaneously hypertensive rats.

    abstract:BACKGROUND AND PURPOSE:We sought to determine the effects of aging on regional cerebral blood flow and ischemic brain damage in transient cerebral ischemia in rats. METHODS:Five adult (5-6 months) and five aged (18-22 months) female spontaneously hypertensive rats were subjected to 20 minutes of bilateral carotid occl...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.22.11.1414

    authors: Yao H,Sadoshima S,Ooboshi H,Sato Y,Uchimura H,Fujishima M

    更新日期:1991-11-01 00:00:00

  • Systemic inflammatory response syndrome in tissue-type plasminogen activator-treated patients is associated with worse short-term functional outcome.

    abstract:BACKGROUND AND PURPOSE:Systemic inflammatory response syndrome (SIRS) is a generalized inflammatory state. The primary goal of the study was to determine whether differences exist in outcomes in SIRS and non-SIRS intravenous tissue-type plasminogen activator-treated patients. METHODS:Consecutive patients were retrospe...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.001371

    authors: Boehme AK,Kapoor N,Albright KC,Lyerly MJ,Rawal PV,Bavarsad Shahripour R,Alvi M,Houston JT,Sisson A,Beasley TM,Alexandrov AW,Alexandrov AV,Miller DW

    更新日期:2013-08-01 00:00:00