“…40 The mechanically based mechanisms involve the direct evacuation of IVH under endoscopic visualization, either using the endoscope itself or an adjunctive device. 26 In most IVH patients, the placement of an EVD represents standard treatment, for this reason, the administration of a lytic agent through an in situ catheter represents a minimal extension of the standard care already being delivered. However, the disadvantages of this method include the potential for lytic-induced expansion of the original hemorrhage, infection from repeated access of the EVD catheter, the prolonged period of time (typically 2-4 days) required for adequate clearance of blood products, and potentially the failure of the technique to achieve a substantial reduction in IVH volume in some patients.…”