3D-Printed Endoport vs. Open Surgery for Evacuation of Deep Intracerebral Hemorrhage. (29th September 2022)

• Record Type: Journal Article
• Authors: Garcia-Estrada, Everardo; Morales-Gómez, Jesús Alberto; Garza-Báez, Azalea; Sotomayor-González, Arturo; Palacios-Ortiz, Isaac Jair; Mercado-Flores, Mariana; Martínez-Ponce de León, Angel Raymundo
• Is Part Of: Canadian journal of neurological sciences. Volume 49:Number 5(2022)
• Page Start: 636
• Page End: 643
• Publication Date: 2022-09-29
• Subjects: 3D printing -- Craniotomy -- Endoport -- Hemorrhagic stroke -- Intracerebral hemorrhage -- Minimally invasive surgery; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Electronic journals; 616.8
• DOI: 10.1017/cjn.2021.185
• Languages: English
• ISSNs: 0317-1671

Abstract

ABSTRACT: 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.