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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
09:01

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

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Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective

Hui-Tzung Luh1, Abel Po-Hao Huang1, Shih-Hung Yang1

  • 1Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|March 28, 2017
PubMed
Abstract

Insights

Minimally invasive endoscope-assisted evacuation for intracerebral hemorrhage (ICH) using FloSeal Hemostatic Matrix effectively controlled bleeding. This technique improved hemostasis, reduced operative time, and showed promising outcomes in patients with spontaneous ICH.

Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Hemorrhage Management

Background:

  • Minimally invasive endoscope-assisted (MIE) evacuation is effective for spontaneous intracerebral hemorrhage (ICH).
  • Limited working space in MIE can compromise hemostasis, potentially leading to rebleeding.
  • Effective intraoperative hemorrhage management is critical for MIE success.

Purpose of the Study:

  • To evaluate the safety and efficacy of FloSeal Hemostatic Matrix for hemostasis during MIE evacuation of ICH.
  • To assess the impact of FloSeal on rebleeding rates, morbidity, and mortality.
  • To analyze the effectiveness of MIE with FloSeal in various ICH types.

Main Methods:

  • Retrospective analysis of 42 patients undergoing MIE evacuation of ICH followed by FloSeal injection.
  • Primary endpoints included rebleeding, morbidity, and mortality.
  • Hematoma evacuation percentage (CT scans) and Extended Glasgow Outcome Scale (GOSE) at 6 months were assessed.

Main Results:

  • Surgery-related mortality was low at 2.4%.
  • Average hematoma evacuation was 80.8% with a low rebleeding rate of 4.8%.
  • Mean operative time was 102.7 minutes; mean postoperative GOSE score was 4.55 at 6 months.

Conclusions:

  • Local application of FloSeal Hemostatic Matrix is safe and effective for hemostasis in MIE ICH evacuation.
  • The technique appears to shorten operation time, particularly in cases with intraoperative bleeding.
  • Further validation through large, prospective, randomized trials is recommended.
Keywords:
Endoscope-assisted surgeryFloSeal Hemostatic MatrixLocal hemostatic agentMinimally invasive surgerySpontaneous intracerebral hemorrhage

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