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Patra DP, Welz ME, Turcotte EL, et al. Real-Time MRI-Guided Stereotactic Aspiration of Spontaneous Intracerebral Hematoma: A Preclinical Feasibility Study. Oper Neurosurg (Hagerstown). 2022;22(2):80-86doi: 10.1227/ONS.0000000000000005.
Patra, D. P., Welz, M. E., Turcotte, E. L., Pandey, R., Vij, K., Daly, M., Rabon, M., Korszen, S., Zhou, Y., Halpin, B., Marchese, M. L., Syal, A., Krishna, C., & Bendok, B. R. (2022). Real-Time MRI-Guided Stereotactic Aspiration of Spontaneous Intracerebral Hematoma: A Preclinical Feasibility Study. Operative neurosurgery (Hagerstown, Md.), 22(2), 80-86. https://doi.org/10.1227/ONS.0000000000000005
Patra, Devi P, et al. "Real-Time MRI-Guided Stereotactic Aspiration of Spontaneous Intracerebral Hematoma: A Preclinical Feasibility Study." Operative neurosurgery (Hagerstown, Md.) vol. 22,2 (2022): 80-86. doi: https://doi.org/10.1227/ONS.0000000000000005
Patra DP, Welz ME, Turcotte EL, Pandey R, Vij K, Daly M, Rabon M, Korszen S, Zhou Y, Halpin B, Marchese ML, Syal A, Krishna C, Bendok BR. Real-Time MRI-Guided Stereotactic Aspiration of Spontaneous Intracerebral Hematoma: A Preclinical Feasibility Study. Oper Neurosurg (Hagerstown). 2022 Feb 01;22(2):80-86. doi: 10.1227/ONS.0000000000000005. PMID: 35007273.
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Oper Neurosurg (Hagerstown). 2022 Feb 01;22(2):80-86. doi: 10.1227/ONS.0000000000000005.

Real-Time MRI-Guided Stereotactic Aspiration of Spontaneous Intracerebral Hematoma: A Preclinical Feasibility Study.

Operative neurosurgery (Hagerstown, Md.)

Devi P Patra, Matthew E Welz, Evelyn L Turcotte, Rajesh Pandey, Kamal Vij, Max Daly, Matthew Rabon, Stephanie Korszen, Yuxiang Zhou, Brooke Halpin, Marco L Marchese, Arjun Syal, Chandan Krishna, Bernard R Bendok

Affiliations

  1. Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.
  2. Precision Neurotherapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.
  3. Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.
  4. ClearPoint Neuro, Inc., Irvine, California, USA.
  5. Department of Radiology, Mayo Clinic, Phoenix, Arizona, USA.
  6. School of Life Sciences, Arizona State University, Tempe, Arizona, USA.
  7. Chaparral High School, Scottsdale, Arizona, USA.
  8. Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, USA.

PMID: 35007273 DOI: 10.1227/ONS.0000000000000005

Abstract

BACKGROUND: Minimally invasive surgical techniques have reinvigorated the role of surgical options for spontaneous intracranial hematomas; however, they are limited by the lack of real-time feedback on the extent of hematoma evacuation.

OBJECTIVE: To describe the development of a MRI-guided catheter-based aspiration system, the ClearPoint Pursuit Neuroaspiration Device (ClearPoint Neuro) and validation in phantom models.

METHODS: In this preclinical experimental trial, 8 phantom brains with skull models were created to simulate an intracranial hematoma with 2 clot sizes, 30 cc (small clot) and 60 cc (large clot). After registration, the aspiration catheter (Pursuit device) was aligned to the desired planned trajectory. The aspiration of the clot was performed under real-time MRI scan in 3 orthogonal views. The primary end point was reduction of the clot volume to less than 15 cc or 70% of the original clot volume.

RESULTS: Successful completion of clot evacuation was achieved in all models. The average postaspiration clot volume was 9.5 cc (8.7 cc for small clots and 10.2 cc for large clots). The average percentage reduction of clot volume was 76.3% (range 58.7%-85.2%). The average total procedure time (from frame registration to final postaspiration clot assessment) was 50 min. The average aspiration time was 6.9 min.

CONCLUSION: This preclinical trial confirms the feasibility and efficacy of MRI-guided aspiration under real-time image guidance in simulation models for intracranial hematoma. Clinical use of the system in patients would further validate its efficacy and safety.

Copyright © Congress of Neurological Surgeons 2021. All rights reserved.

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