ICH Trial Update-Spontaneous Intracerebral Hemorrhage (ICH): MISTIE III Results and Future Directions

Video Transcription

Video Summary

The video is a presentation discussing the topic of spontaneous intracerebral hemorrhage (ICH), its prognosis, and current treatment options. The speaker begins by correcting a mispronunciation and continues to explain that ICH is a type of hemorrhagic stroke with a poor prognosis, especially compared to ischemic strokes. The 30-day mortality rate is influenced by factors such as the size of the ICH, presence of blood in the intraventricular system, and amount of edema. Most survivors require long-term follow-up and dependence on others. The speaker then explains the standard of care, which focuses on preventing hematoma expansion and providing supportive care. Surgical evacuation of ICHs has not been commonly performed due to lack of supporting evidence. The speaker presents results from the MISTIE 2 study, which showed promising outcomes with minimally invasive surgery. However, the more recent MISTIE 3 trial did not demonstrate a significant advantage for surgical treatment. The speaker concludes by mentioning ongoing studies and the need for further research to improve outcomes for ICH patients. The speaker also introduces the INVEST study, a single-arm feasibility study examining the surgical treatment using the Apollo Artemis system. The study aims to assess the safety and efficacy of the procedure and gather real-world data through a registry for patients who do not qualify for the study. The video provides an overview of the study's inclusion and exclusion criteria, schedule of assessments, and procedure details. The speaker states that the study is currently ongoing and encourages other centers to join if interested.

Asset Subtitle

Robert F. James, MD, FAANS

Keywords

spontaneous intracerebral hemorrhage

prognosis

treatment options

MISTIE 2 study

surgical treatment