Jingjing Wang , Shenhao Chen , Ziyang Zhang , Ruoru Wu , Ye Li
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Primary outcomes included operative metrics, complications, and 3-month functional outcomes(modified Rankin Scale [mRS], Barthel Index [BI]).</div></div><div><h3>Results</h3><div>MISCD-UK significantly reduced operative duration(58 vs. 257.5 min, <em>P</em> < 0.001) and blood loss (5 mL vs. 225 mL, <em>P</em> < 0.001). ICU and hospital stays were shorter with MISCD-UK (ICU: 8 vs. 16.5 days, <em>P</em> = 0.005; total hospital stay: 9.5 vs. 17 days, <em>P</em> = 0.012). However, 3-month functional outcomes were similar (mRS 0–3: 36.7 % MISCD-UK vs. 50 % CHE, <em>P</em> = 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 5","pages":"Pages 220-226"},"PeriodicalIF":1.3000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Robot-guided catheter drainage with urokinase versus craniotomy hematoma evacuation for spontaneous intracerebral hemorrhage: A retrospective study\",\"authors\":\"Jingjing Wang , Shenhao Chen , Ziyang Zhang , Ruoru Wu , Ye Li\",\"doi\":\"10.1016/j.hest.2025.08.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>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).</div></div><div><h3>Methods</h3><div>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]).</div></div><div><h3>Results</h3><div>MISCD-UK significantly reduced operative duration(58 vs. 257.5 min, <em>P</em> < 0.001) and blood loss (5 mL vs. 225 mL, <em>P</em> < 0.001). ICU and hospital stays were shorter with MISCD-UK (ICU: 8 vs. 16.5 days, <em>P</em> = 0.005; total hospital stay: 9.5 vs. 17 days, <em>P</em> = 0.012). However, 3-month functional outcomes were similar (mRS 0–3: 36.7 % MISCD-UK vs. 50 % CHE, <em>P</em> = 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":33969,\"journal\":{\"name\":\"Brain Hemorrhages\",\"volume\":\"6 5\",\"pages\":\"Pages 220-226\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain Hemorrhages\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589238X25000683\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain Hemorrhages","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589238X25000683","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
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。
Robot-guided catheter drainage with urokinase versus craniotomy hematoma evacuation for spontaneous intracerebral hemorrhage: A retrospective study
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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