The Stereotactic Intracerebral Hemorrhage Underwater Blood Aspiration (SCUBA) technique for minimally invasive endoscopic intracerebral hemorrhage evacuation.
The Stereotactic Intracerebral Hemorrhage Underwater Blood Aspiration (SCUBA) technique for minimally invasive endoscopic intracerebral hemorrhage evacuation.
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DOI：
10.1136/neurintsurg-2017-013719
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发表时间：
2018-08
影响因子：
4.8
通讯作者：
Mocco J
中科院分区：
文献类型：
--
作者：
Kellner CP;Chartrain AG;Nistal DA;Scaggiante J;Hom D;Ghatan S;Bederson JB;Mocco J
内窥镜脑出血（ICH）引流技术作为一种潜在的治疗选择已经引起了人们的兴趣。然而，所采用的仪器和技术仍在不断改进，以优化止血和排泄效率。我们描述了一种特殊的内窥镜技术在脑出血治疗中的应用，称为立体定向脑出血水下吸血（SCUBA）技术。它不同于先前描述的微创脑出血干预，因为它在两个阶段结合了两种独立的神经内窥镜策略，第一阶段在旱地条件下，第二阶段使用湿地策略。所有在2015年12月至2017年9月期间使用SCUBA技术进行内窥镜颅内出血引流的患者均被纳入研究。47例患者采用了水肺技术。平均抽离率为88.2% （SD 20.8）。在23例（48.9%）病例中观察到来自特定来源的活动性出血。活动性出血5例（10.6%）只用冲洗处理，18例（38.3%）需要电灼。术中出血3例（6.4%），术后出血1例（2.1%）。水肺技术为外科医生提供了一个明确的策略来进行真正的内窥镜血肿清除。特别是，与传统的充气策略相比，SCUBA第2阶段的充液腔具有几个潜在的优势，包括清晰地识别和烧灼出血血管，以及可视化残余血块负担。将这种技术与目前使用的其他技术进行比较需要进一步的研究。
Endoscopic intracerebral hemorrhage (ICH) evacuation techniques have gained interest as a potential therapeutic option. However, the instrumentation and techniques employed are still being refined to optimize hemostasis and evacuation efficiency. We describe the application of a specific endoscopic technique in the treatment of ICH called the Stereotactic Intracerebral Hemorrhage Underwater Blood Aspiration (SCUBA) technique. It differs from previously described minimally invasive ICH interventions in that it combines two separate neuroendoscopic strategies in two phases, the first under dry-field conditions and the second using a wet-field strategy. All patients who underwent endoscopic ICH evacuation with the SCUBA technique from December 2015 to September 2017 were included. The SCUBA technique was performed in 47 patients. The average evacuation percentage was 88.2% (SD 20.8). Active bleeding identified to derive from a specific source was observed in 23 (48.9%) cases. Active bleeding was addressed with irrigation alone in five cases (10.6%) and required electrocautery in 18 cases (38.3%). Intraoperative bleeding occurred in 3 patients (6.4%) and postoperative bleeding occurred in a single case (2.1%). The SCUBA technique provides surgeons with a defined strategy for true endoscopic hematoma evacuation. In particular, the fluid-filled cavity in SCUBA Phase 2 has the potential to provide several advantages over the traditional air-filled strategy, including clear identification and cauterization of bleeding vessels and visualization of residual clot burden. Further investigation is necessary to compare this technique to others that are currently used.
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影响因子：
2.4
作者：
Nagasaka, T.;Inao, S.;Okamoto, T.
通讯作者：
Okamoto, T.
影响因子：
1.4
作者：
Nishihara, Tetsuhiro;Morita, Akio;Kirino, Takaaki
通讯作者：
Kirino, Takaaki
脑部出血疏散（Mistie）中微创手术加上高度的安全性和功效：一项随机，控制，开放标签，第2期试验。
影响因子：
48
作者：
Hanley, Daniel F.;Thompson, Richard E.;Muschelli, John;Rosenblum, Michael;McBee, Nichol;Lane, Karen;Bistran-Hall, Amanda J.;Mayo, Steven W.;Keyl, Penelope;Gandhi, Dheeraj;Morgan, Tim C.;Ullman, Natalie;Mould, W. Andrew;Carhuapoma, J. Ricardo;Kase, Carlos;Ziai, Wendy;Thompson, Carol B.;Yenokyan, Gayane;Huang, Emily;Broaddus, William C.;Graham, R. Scott;Aldrich, E. Francois;Dodd, Robert;Wijman, Cristanne;Caron, Jean-Louis;Huang, Judy;Camarata, Paul;Mendelow, A. David;Gregson, Barbara;Janis, Scott;Vespa, Paul;Martin, Neil;Awad, Issam;Zuccarello, Mario
通讯作者：
Zuccarello, Mario
影响因子：
8.3
作者：
Mould WA;Carhuapoma JR;Muschelli J;Lane K;Morgan TC;McBee NA;Bistran-Hall AJ;Ullman NL;Vespa P;Martin NA;Awad I;Zuccarello M;Hanley DF;MISTIE Investigators
通讯作者：
MISTIE Investigators
影响因子：
4.8
作者：
Fiorella, David;Arthur, Adam;Schafer, Sebastian
通讯作者：
Schafer, Sebastian