Nav: Home

Removing more blood via minimally invasive surgery more likely to improve hemorrhagic stroke recover

February 07, 2019

HONOLULU, Feb. 7, 2019 -- The greater the volume of blood removed from the brain via minimally invasive surgery after a cerebral hemorrhage the greater the odds of better functional recovery, according to late breaking science presented at the American Stroke Association's International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease.

Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation (MISTIE) is the stereotactic catheter aspiration and clearance of large bleeds within the brain, with the clot-buster alteplase.

The MISTIE III trial is the first surgical trial assessment of whether greater removal of blood impacts the likelihood of favorable functional outcome after one year and factors associated with greater efficiency of blood removal.

Among 506 intracerebral hemorrhage (ICH) cases enrolled in the trial, 242 ICH patients (average age 62, 63 percent male) underwent the MISTIE III surgical procedure by 110 surgeons at 73 sites, with follow-up at one year. The trial excluded patients whose bleeding had not stabilized, and cases with cerebellar and brainstem hemorrhage.

Researchers found that among cases undergoing the MISTIE III surgical procedure, removing blood volume by 70 percent or more, or leaving 15 milliliters or less of residual blood at the end of treatment were twice as likely to achieve milder disability one year later. Lesser removal was needed to avoid mortality, but the patients who had less than 70 percent of the blood removed, or more than 15 mL residual blood, had no difference in disability than patients treated with medical therapy, or those with lesser removal.

Researchers noted that more efficient ICH evacuation was more likely accomplished in cases with certain shapes of hematoma, where the surgical protocol was rigorously followed and by surgeons and sites with greatest experience in MISTIE technique.

"When assessing the results of surgery for brain hemorrhage, it is critical to consider how much blood was successfully evacuated. Unless a large majority of clot is removed and only a very small residual of blood is left, the full benefits of surgery will not be realized," said Issam A. Awad, M.D, M.Sc., study lead author and director of Neurovascular Surgery at the University of Chicago Medicine and Biological Sciences. "This had never been considered as a factor in the success or failure of such surgeries and cannot be taken for granted."

Co-authors and disclosures are noted on the abstract.
-end-
The National Institute of Neurological Disorders and Stroke (NINDS) funded the study.

Note: Scientific presentation is 11:12 a.m. Hawaii Time/4:12 p.m. Eastern Time, Friday, Feb. 8, 2019.

Additional Resources:

* VIDEO: Miguel Perez-Pinzon, Ph.D., FAHA, Chair, International Stroke Conference 2019 Program Committee, offers overviews and perspective on late breaking science via downloadable Skype video (transcript provided) available on the right column of the release link https://newsroom.heart.org/news/removing-more-blood-via-minimally-invasive-surgery-more-likely-to-improve-hemorrhagic-stroke-recovery?preview=efe756e2ab28ad94139007e679524e88

* For more news from AHA International Stroke Conference 2019, follow us on Twitter @HeartNews #ISC19.

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke -- the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit StrokeAssociation.org. Follow us on Facebook and Twitter.

American Heart Association

Related Brain Articles:

Study describes changes to structural brain networks after radiotherapy for brain tumors
Researchers compared the thickness of brain cortex in patients with brain tumors before and after radiation therapy was applied and found significant dose-dependent changes in the structural properties of cortical neural networks, at both the local and global level.
Blue Brain team discovers a multi-dimensional universe in brain networks
Using a sophisticated type of mathematics in a way that it has never been used before in neuroscience, a team from the Blue Brain Project has uncovered a universe of multi-dimensional geometrical structures and spaces within the networks of the brain.
New brain mapping tool produces higher resolution data during brain surgery
Researchers have developed a new device to map the brain during surgery and distinguish between healthy and diseased tissues.
Newborn baby brain scans will help scientists track brain development
Scientists have today published ground-breaking scans of newborn babies' brains which researchers from all over the world can download and use to study how the human brain develops.
New test may quickly identify mild traumatic brain injury with underlying brain damage
A new test using peripheral vision reaction time could lead to earlier diagnosis and more effective treatment of mild traumatic brain injury, often referred to as a concussion.
This is your brain on God: Spiritual experiences activate brain reward circuits
Religious and spiritual experiences activate the brain reward circuits in much the same way as love, sex, gambling, drugs and music, report researchers at the University of Utah School of Medicine.
Brain scientists at TU Dresden examine brain networks during short-term task learning
'Practice makes perfect' is a common saying. We all have experienced that the initially effortful implementation of novel tasks is becoming rapidly easier and more fluent after only a few repetitions.
Balancing time & space in the brain: New model holds promise for predicting brain dynamics
A team of scientists has extended the balanced network model to provide deep and testable predictions linking brain circuits to brain activity.
New view of brain development: Striking differences between adult and newborn mouse brain
Spikes in neuronal activity in young mice do not spur corresponding boosts in blood flow -- a discovery that stands in stark contrast to the adult mouse brain.
Map of teenage brain provides evidence of link between antisocial behavior and brain development
The brains of teenagers with serious antisocial behavior problems differ significantly in structure to those of their peers, providing the clearest evidence to date that their behavior stems from changes in brain development in early life, according to new research led by the University of Cambridge and the University of Southampton, in collaboration with the University of Rome Tor Vergata in Italy.

Related Brain Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".