3D-Printed Endoport vs. Open Surgery for Evacuation of Deep Intracerebral Hemorrhage

被引:3
作者
Garcia-Estrada, Everardo [1 ]
Morales-Gomez, Jesus Alberto [1 ]
Garza-Baez, Azalea [1 ,2 ]
Sotomayor-Gonzalez, Arturo
Palacios-Ortiz, Isaac Jair [1 ]
Mercado-Flores, Mariana [2 ]
Martinez-Ponce de Leon, Angel Raymundo [1 ]
机构
[1] Univ Autonoma Nuevo Leon, Dr Jose Eleuterio Gonzalez Univ Hosp, Neurosurg & Neuroendovasc Therapy Dept, Monterrey, Nuevo Leon, Mexico
[2] Univ Autonoma Nuevo Leon, Univ Ctr Diagnost Imaging, Dr Jose Eleuterio Gonzalez Univ Hosp, Neuroradiol Div, Monterrey, Nuevo Leon, Mexico
关键词
3D printing; Craniotomy; Endoport; Hemorrhagic stroke; Intracerebral hemorrhage; Minimally invasive surgery; MINIMALLY INVASIVE SURGERY; INITIAL CONSERVATIVE TREATMENT; LONG-TERM SURVIVAL; STROKE; POPULATION; MANAGEMENT; HEMATOMAS; METAANALYSIS; GUIDELINES; PROGNOSIS;
D O I
10.1017/cjn.2021.185
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Large-sized clinical trials have failed to show an overall benefit of surgery over medical treatment in managing spontaneous intracerebral hemorrhages (ICH); less invasive techniques have shown to decrease brain injury caused by surgical manipulation in the standard open approach improving the clinical outcomes of patients. Thereby, we propose a low-cost 3D-printed endoport for a less invasive ICH evacuation. In this study, the authors compare the clinical outcomes of early surgical evacuation using a 3D-printed endoport vs. a standard open surgery (OS). Methods: A retrospective analysis was conducted comparing patients who underwent early evacuation of a deep hypertensive ICH through an endoport vs. OS at a single center from August 2017 to March 2019. Demographic, clinical, and radiologic data were reviewed. The primary outcomes were the 90-day post-stroke functional outcome and mortality. Results: A total of 36 patients were included. The two cohorts (18 endoport; 18 OS) showed no statistically significant differences in demographic, clinical, and radiologic characteristics, including median admission hemorrhage volume, Glasgow Coma Scale, and ICH scores. At 90-day post-stroke, 44% of patients in the endoport group and 17% in the OS group had a favorable functional outcome (mRS 0-3) (p = 0.039); moreover, the endoport group showed lower mortality (33% vs. 72%, p = 0.019). Conclusions: This study suggests that an endoport-assisted ICH evacuation may have better functional outcomes and lower mortality than OS. The proposed device could provide a safe, low-cost alternative for ICH's surgical treatment. More rigorous research is hence needed to assess the potential benefits of this technique.
引用
收藏
页码:636 / 643
页数:8
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