Related Experiment Video
Updated: Apr 14, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
CT Fluoroscopy-guided Aspiration of Intracerebral Hematomas: Technique and Outcomes
Kihwan Hwang1, Gyojun Hwang1, O-Ki Kwon1
1Department of Neurosurgery, Regional Cardiocerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
Insights
CT-guided aspiration of intracerebral hematomas (ICH) is a feasible and accurate procedure. This technique allows for effective hematoma removal and drainage, offering a potential alternative to stereotactic methods.
Area of Science:
- Neurosurgery
- Medical Imaging
- Interventional Radiology
Background:
- Intracerebral hematomas (ICH) pose significant management challenges.
- Minimally invasive techniques are sought for ICH evacuation.
Purpose of the Study:
- To assess the feasibility and accuracy of CT fluoroscopy (CTF)-guided catheter placement and aspiration for ICH.
- To evaluate the safety and efficacy of CTF-guided ICH aspiration.
Main Methods:
- Nine patients with ICH underwent CTF-guided hematoma aspiration under local anesthesia.
- Evaluation included targeting accuracy, hematoma volume aspirated, procedure time, and clinical outcomes.
Main Results:
- Successful catheter placement in the hematoma center was achieved in all cases.
- Mean aspirated hematoma volume was 20.6 mL; average procedure time was 25.1 minutes.
- No procedure-related complications such as rebleeding or infection were observed.
Conclusions:
- CTF-guided ICH aspiration is a feasible, rapid, and accurate minimally invasive procedure.
- Real-time guidance ensures precise catheter positioning for effective hematoma aspiration and drainage.
- This technique may serve as a viable substitute for traditional stereotactic methods.
Objective:
The authors evaluated the feasibility and targeting accuracy of CT fluoroscopy (CTF)-guided catheter placement and aspiration of intracerebral hematoma (ICH)s.
Materials And Methods:
Nine patients (mean age, 63.3 ± 15.3 years) were treated by CTF-guided hematoma aspiration under local anesthesia. The targeting errors in the lesion center, volume of the aspirated hematoma, accuracy of the final catheter position, procedure time, and clinical outcomes were evaluated.
Results:
All catheters were successfully placed in the center of the hematoma. The mean volume of the aspirated hematoma was 20.6 ± 8.8 mL (pre-treatment, 44.7 ± 20.1 mL; post-treatment, 24.1 ± 13.8 mL). The average procedure time was 25.1 minutes (range, 18-32 minutes). In one case with a scanty residual hematoma, the catheter was removed at the end of the procedure. In the remaining eight cases, the catheter was left in the residual hematoma for drainage and all catheter tips were accurately located in the final position. There were no procedure-related complications, including rebleeding and infection.
Conclusion:
CTF-guided ICH aspiration is a feasible, quick, and accurate procedure which could substitute for stereotactic methods. The accurate catheter position provided by real-time observation enables an effective aspiration and drainage of hematomas.
