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Related Experiment Video

Updated: Jul 6, 2025

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
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Continuous irrigation with thrombolytics for intraventricular hemorrhage: case-control study.

Diego A Carrera1, Marc C Mabray2, Michel T Torbey1

  • 1Department of Neurology, University of New Mexico, Albuquerque, NM, USA.

Neurosurgical Review
|January 10, 2024
PubMed
Summary

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Intraventricular hemorrhage (IVH) treatment using the novel IRRAflow system with tissue plasminogen activator (t-PA) showed improved outcomes. This irrigating external ventricular drain (EVD) reduced drain days and improved patient functional status.

Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Intraventricular hemorrhage (IVH) is a severe complication of intracerebral hemorrhage.
  • Standard treatment involves external ventricular drain (EVD) placement.
  • Intraventricular thrombolysis can improve mortality but not functional outcomes.

Purpose of the Study:

  • To evaluate the initial experience with a novel irrigating EVD (IRRAflow) system.
  • To assess the feasibility and safety of automated continuous irrigation with thrombolysis for IVH.
  • To compare outcomes between standard EVD and IRRAflow treatment.

Main Methods:

  • A single-center case-control study comparing patients with IVH treated with EVD versus IRRAflow.
  • Demographic, treatment, and outcome parameters were analyzed.
Keywords:
Continuous irrigationIntracerebral hemorrhageIntraventricular hemorrhageIntraventricular thrombolysis

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  • A brain phantom model was used to assess clot clearance efficacy.

    • Main Results:

    • IRRAflow patients received thrombolysis more frequently (89% vs 33%).
    • IRRAflow significantly reduced mean drain days (4.1 vs 8.8) and days to clearance (2.5 vs 5.8).
    • IRRAflow patients showed significantly better functional outcomes at 90 days (86% vs 37% mRS ≥ 3).

    Conclusions:

    • Irrigation with IRRAflow and tissue plasminogen activator (t-PA) is feasible and safe for IVH patients.
    • The IRRAflow system may improve clot clearance, potentially leading to better clinical outcomes.
    • Further investigation in randomized trials is warranted to confirm these findings.