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Updated: Jul 10, 2026

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
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Thrombolytics in intraventricular hemorrhage.

Paul Nyquist1, Shannon LeDroux, Romergryko Geocadin

  • 1Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 8-138, Baltimore, MD 21287-7840, USA. pnyquis1@jhmi.edu

Current Neurology and Neuroscience Reports
|November 15, 2007
PubMed
Summary

Intraventricular hemorrhage (IVH) treatment with thrombolytics shows promise. Early data from the CLEAR IVH trial suggest this approach may safely reduce clot lysis time and potentially lower mortality in patients with brain bleeds.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pharmacology

Background:

  • Intraventricular hemorrhage (IVH) presents significant mortality and morbidity risks.
  • IVH can be primary or secondary to other brain hemorrhages.
  • Current treatment options for IVH are limited.

Purpose of the Study:

  • To evaluate the safety and efficacy of intraventricular thrombolytics for IVH clot lysis.
  • To present preliminary findings from the CLEAR IVH trial.
  • To review thrombolytic use in secondary IVH.

Main Methods:

  • Administration of thrombolytic drugs via external ventricular drain.
  • Prospective, randomized clinical trial design (CLEAR IVH).
  • Review of existing literature on thrombolytics for secondary IVH.

Main Results:

  • Intraventricular thrombolytic administration is safe.
  • Preliminary data show reduced time to clot lysis.
  • Potential reduction in IVH-associated mortality observed.

Conclusions:

  • Intraventricular thrombolytics offer a promising therapeutic strategy for IVH.
  • The CLEAR IVH trial provides encouraging preliminary evidence.
  • Further phase III trials are planned to confirm clinical efficacy.