Endoscope-assisted microsurgical evacuation versus external ventricular drainage for the treatment of cast intraventricular hemorrhage: results of a comparative series

Rienzo, Alessandro Dı; Colasanti, Roberto; Esposito, Domenic; Costanza, Martina Della; Carrassi, Erika; Capece, Mara; Aiudi, Denis; Iacoangeli, Maurizio

doi:10.1007/s10143-019-01110-7

Cited by 15 publications

(11 citation statements)

References 27 publications

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“…Of the included studies, three were randomized controlled trials 10 12 17 and the remaining two were retrospective studies. 1 21 A total of 303 patients were considered for statistical analysis. The main variables of the included studies are reported in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…No sufficient data were available to describe the postprocedure Graeb score. Di Rienzo et al reported an EVD occlusion of 0% in the NE group but in the EVD-only group, 26 and 18.5% of patients present temporary or permanent occlusion, respectively 21. Regarding the length of stay, Chen et al and Basaldella et al reported a mean intensive care unit (ICU) stay of 18.5 and 12 days in the EVD and NE group, respectively 1,12.…”

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confidence: 99%

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Endoscopic Evacuation of Massive Intraventricular Hemorrhages Reduces Shunt Dependency: A Meta-Analysis

et al. 2022

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Intraventricular hemorrhage (IVH) is characterized by severe prognosis. The amount of intraventricular blood is the most important, disease-specific, prognostic factor, as acute complications are strictly dependent on clot formation. Although external ventricular drain (EVD) placement is the standard treatment, in the past 15 years neuroendoscopic (NE) evacuation of IVH has been advocated, but available comparative data are limited. A systematic review of the literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles compare the treatment of primary and secondary IVH with NE and EVD. The meta-analysis was performed in terms of shunt dependency. Cochran's Q-test and I2 statistics were used to assess heterogeneity in the studies. No heterogeneity was considered for p greater than 0.05 and I2 less than 20%. A random-effect model was used, with restricted maximum likelihood to estimate the heterogeneity variance. After screening 744 articles, 5 were included in the meta-analysis. A total of 303 patients presenting with primary or pure (50 patients) and secondary (253 patients) IVH, undergoing either NE (151) or EVD (152), were included in the metanalysis. The risk of ventriculoperitoneal (VP) shunt was higher in the EVD group (relative risk: 1.93, 95% confidence interval: 1.28–2.92, p = 0.0094). The risk of VP shunt was higher in the EVD group, but the overall outcome remains poor for patients with IVH, with a moderate-to-high disability. Large randomized controlled trials are needed to evaluate more deeper both advantages and effects on the outcome of NE over EVD.

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Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Endoscopic Evacuation of Massive Intraventricular Hemorrhages Reduces Shunt Dependency: A Meta-Analysis

et al. 2022

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“…Results from their study demonstrated that endoscopic evacuation reduced ICU stay, reduced CSF clearance times, and showed a small mortality benefit. Shunt rates were not significantly different [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Drainage, Irrigation, and Fibrinolytic Therapy (DRIFT) for Adult Intraventricular Hemorrhage Using IRRAflow® Self-Irrigating Catheter

Rajjoub

Hess

O’Connor

et al. 2021

Cureus

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Intraventricular hemorrhage (IVH) is a devastating neurosurgical condition associated with high rates of morbidity and mortality. It can occur as the result of several pathologies and typically presents with mental status changes, neurologic deficits, seizures, headaches, and decreased Glasgow Coma Scale score. These patients are often treated with placement of an external ventricular drain, which helps decrease the clot burden; however, they commonly clot off leading to multiple exchanges. We present a case in which drainage, irrigation, and fibrinolytic (DRIFT) therapy using IRRAflow® (IRRAS) irrigating catheter was used to treat a patient with severe IVH secondary to aneurysmal subarachnoid hemorrhage.

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“…In addition, Rienzo et al presented a retrospective analysis of the two groups of patients with cast IVH who received endoscopy-assisted surgery or EVD and found that endoscope-assisted evacuation reduced ICU staying and cerebrospinal fluid (CSF) clearance times. Moreover, endoscopy seemed to improve neurological outcomes, but without affecting the need for permanent shunt ( 67 ). However, these are just experience from small case serials and RCTs are needed to evaluate the safety and efficacy of endoscopy treatment for IVH.…”

Section: Minimally Invasive Surgery For Ivhmentioning

confidence: 99%

Minimally Invasive Surgery for Intracerebral and Intraventricular Hemorrhage

et al. 2022

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Spontaneous intracerebral hemorrhage (ICH), especially related to intraventricular hemorrhage (IVH), is the most devastating type of stroke and is associated with high mortality and morbidity. Optimal management of ICH remains one of the most controversial areas of neurosurgery and no effective treatment exists for ICH. Studies comparing conventional surgical interventions with optimal medical management failed to show significant benefit. Recent exploration of minimally invasive surgery for ICH and IVH including catheter- and mechanical-based approaches has shown great promise. Early phase clinical trials have confirmed the safety and preliminary treatment effect of minimally invasive surgery for ICH and IVH. Pending efficacy data from phase III trials dealing with diverse minimally invasive techniques are likely to shape the treatment of ICH.

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Endoscope-assisted microsurgical evacuation versus external ventricular drainage for the treatment of cast intraventricular hemorrhage: results of a comparative series

Cited by 15 publications

References 27 publications

Endoscopic Evacuation of Massive Intraventricular Hemorrhages Reduces Shunt Dependency: A Meta-Analysis

Endoscopic Evacuation of Massive Intraventricular Hemorrhages Reduces Shunt Dependency: A Meta-Analysis

Drainage, Irrigation, and Fibrinolytic Therapy (DRIFT) for Adult Intraventricular Hemorrhage Using IRRAflow® Self-Irrigating Catheter

Minimally Invasive Surgery for Intracerebral and Intraventricular Hemorrhage

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