• World Neurosurg · Dec 2022

    A minimal invasive drainage of intracerebral hemorrhage. A South American experience with MISTIE procedure.

    • Carlos Gustavo Videla, Pedro Plou, Libardo Valencia Chicue, Claudio Yampolsky, Pablo Marcelo Ajler, and Nicolas Marcelo Ciarrocchi.
    • Adult Intensive Care Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: carlos.videla@hospitalitaliano.org.ar.
    • World Neurosurg. 2022 Dec 1; 168: 9510295-102.

    BackgroundIntracerebral hemorrhage (ICH) is the second most common subtype of stroke but is associated with greater rates of disability or mortality. One of the factors of a poor prognosis is large hematoma volume. The MISTIE III trial with the aim of decreasing clot size showed that the greater the ICH reduction, the higher likelihood of lower mortality without a net increase in the proportion of patients with severe disability. Our aim is to describe our experience with treating selective patients with ICH per the MISTIE trial protocol in a university hospital in Argentina during 4 years.MethodsA retrospective analysis was performed of consecutive patients with ICH treated at a single university tertiary-care center from 2017 to 2021 with the MISTIE protocol.ResultsWe deployed this procedure in 7 patients with a median age of 61 years, median National Institutes of Health Stroke Scale score of 14, an ICH volume of 35 mL and median ICH score of 2. Five of 7 patients achieved the target goal of hematoma reduction; 4 of the patients had a total independence level and 1 needed minimal help at 12 months after discharge. Five patients had a good functional outcome (modified Rankin Scale score 0-3 and extended Glasgow Outcome Scale score 4-8) and 2 patients had died but neither because of consequences of thrombolysis of the intracerebral hemorrhage. We did not find bleeding complications during catheter placement, alteplase infusion, or after catheter removal.ConclusionsThe procedure can be carried out safely in Latin American centers that have experience in managing neurocritical patients.Copyright © 2022 Elsevier Inc. All rights reserved.

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