Robot-guided catheter drainage with urokinase versus craniotomy hematoma evacuation for spontaneous intracerebral hemorrhage: A retrospective study

IF 1.3 Q4 CLINICAL NEUROLOGY

Brain Hemorrhages Pub Date : 2025-10-01 DOI:10.1016/j.hest.2025.08.003

Jingjing Wang , Shenhao Chen , Ziyang Zhang , Ruoru Wu , Ye Li

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Abstract

Objective

The management of spontaneous intracerebral hemorrhage(ICH) is a topic of debate. While craniotomy has been the traditional treatment, minimally invasive techniques like robot-guided stereotactic catheter drainage with urokinase(MISCD-UK) have emerged as alternatives. This study compares MISCD-UK with conventional craniotomy hematoma evacuation(CHE).

Methods

A retrospective review of 60 ICH patients treated at Xuanwu Hospital(2023–2025) was conducted, with 30 patients undergoing MISCD-UK and 30 undergoing CHE. Primary outcomes included operative metrics, complications, and 3-month functional outcomes(modified Rankin Scale [mRS], Barthel Index [BI]).

Results

MISCD-UK significantly reduced operative duration(58 vs. 257.5 min, P < 0.001) and blood loss (5 mL vs. 225 mL, P < 0.001). ICU and hospital stays were shorter with MISCD-UK (ICU: 8 vs. 16.5 days, P = 0.005; total hospital stay: 9.5 vs. 17 days, P = 0.012). However, 3-month functional outcomes were similar (mRS 0–3: 36.7 % MISCD-UK vs. 50 % CHE, P = 0.297). Multivariable analysis showed that admission GCS, intraventricular hemorrhage, and anticoagulant use were key predictors of outcomes, while the surgical approach didn’t impact functional recovery.

Conclusion

MISCD-UK provides perioperative advantages over craniotomy but doesn’t improve 3-month functional outcomes, suggesting early neurologic severity and hemorrhage characteristics are crucial for prognosis.

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机器人引导尿激酶导管引流与开颅血肿引流治疗自发性脑出血的回顾性研究

目的自发性脑出血（ICH）的治疗是一个争论不休的话题。虽然开颅术一直是传统的治疗方法，但像机器人引导的尿激酶立体定向导管引流（MISCD-UK）这样的微创技术已经成为替代方案。本研究比较了MISCD-UK与传统开颅血肿清除术（CHE）。方法回顾性分析宣武医院2023-2025年收治的脑出血患者60例，其中30例行MISCD-UK， 30例行CHE。主要结局包括手术指标、并发症和3个月功能结局（改良Rankin量表[mRS]、Barthel指数[BI]）。结果miscd - uk显著缩短手术时间（58分钟vs. 257.5分钟，P < 0.001）和出血量（5 mL vs. 225 mL, P < 0.001）。MISCD-UK的ICU和住院时间较短（ICU: 8天对16.5天，P = 0.005；总住院时间：9.5天对17天，P = 0.012）。然而，3个月的功能结果相似（mRS 0-3: 36.7% MISCD-UK vs 50% CHE, P = 0.297）。多变量分析显示，入院GCS、脑室内出血和抗凝剂使用是预后的关键预测因素，而手术方式对功能恢复没有影响。结论miscd - uk术围手术期优于开颅术，但不能改善3个月的功能预后，提示早期神经系统严重程度和出血特征对预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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