Minimally Invasive Surgery vs Medical Management Alone for Intracerebral Hemorrhage

作者：Adam S Arthur, Babak S. Jahromi, Paul S. Saphier, Christopher Nickele, Robert W. Ryan, Peter Vajkoczy, Clemens M. Schirmer, Christopher P. Kellner, Charles Matouk, Eric J. Arias, Jamie S. Ullman, Michael R. Levitt, Ziad A. Hage, David Fiorella, MIND Study Investigators and Collaborators, Giorgio Paulon, Melanie Quintana, Michelle A. Detry, Anna Bosse, Alexander Norbash, Colin P. Derdeyn, Lee H. Schwamm, Scott Hamilton, Philip M. Meyers, Andrew F. Ducruet, R. Rishi Gupta, Keith Woodward, Padmaja Gutti, William Metcalf-Doetsch, Matthew B. Potts, Kapil Sachdeva, Ronald P. Benitez, Reza Dashti, Eugene Gu, Elzbieta Wirkowski, Khalid Alsherbini, Demi Dawkins, David Dornbos, Lucas Elijovich, Nitin Goyal, Daniel M. Heiferman, Daniel Hoit, Violiza Inoa, Kendrick Johnson, Nickalus R. Khan, Kenneth A. Moore, Bhageeradh Mulpur, Vincent Nguyen, Jeremy Peterson, Radmehr Torabi, Mario Zamora, Mike Mercurio, Fatima Milfred, Steven O’Donnell, Viren Patel, Rene O. Sanchez-Mejia, Sami Czabanka, Kiarash Ferdowssian, Nils Hecht, Christoph Leithner, Lars Wessels, Oded Goren, Christoph J. Griessenauer, Philipp Hendrix, Yasser Khorchid, Matthew J. Kole, Itay Melamed, Gregory M. Weiner, J Mocco, Branden Cord, Ryan Hebert, Andrew B. Koo, Andrew Bauerschmidt, Amir R. Dehdashti, Jason A. Ellis, Shahab Khazanehdari, Jungmin Kim, David Langer, David LeDoux, Zachary David Levy, Krista Lim-Hing, Ashesh D. Mehta, Aashish Patel, Tania Rebeiz, Kenia Samuel, Heustein Sy, Richard E. Temes, David Weintraub, Gregory Imbarrato, Sami Al Kasab, Charles M. Andrews, Elizabeth Callan, Michael Casey, Guilherme Porto, Ryan T. Kellogg, Kimberly Kicielinski, Jonathan Lena, Suhas Pai, Danuel Snelgrove, Alejandro M Spiotta, Raymond D Turner, Ifeanyi Iwuchukwu, Joseph R. Keen, Harold McGrade, Basit Rahim, Vikas Rao, Courtney Strifler, J.S. Fraser, Benjamin Carroll, Paul Clark, Nicholas P. Derrico, Daniel Durán, Patrick Kim, Rebekah Kimball, Christa O’Hana S. Nobleza, Christopher J. Seward, Zachary S. Smalley, Andrew M. Smith, Allison Strickland, Kelsey Walsh, Chad W. Washington, Michael K. Ziemke, Adnan N. Qureshi, Farhan Siddiq, Cian O′Kelly, Maximilian-Niklas Bonk, Micol Colosimo, Hauke Schneider, Ehab Shiban, Bjoern Sommer, Christina Wolfert, T. Bowen, Trisha Dickey, Stefan A. Dupont, Alan Hoffer, Yin Hu, Abhishek Ray, Warren R. Selman, Berje Shammassian, Wei Xiong, Michael Schneck, Joseph C. Serrone, Ilya Levin, Daniel Zumofen, Kai Bansemir, Jens Lehmberg, Manuel Buitrago Blanco, Geoffrey P. Colby, Paul Vespa, Anthony Wang, Constantin Hecker, Helmut F. Novak, Slaven Pikija, Sohum Desai, Ameer E Hassan, Emun Abdu, Mark Baker, Fernando Mayor Basto, Kathleen Burger, Chris Leon-Guerrero, Dimitri Sigounas, Ramy Amirah, Katerina Argiti, Jürgen Beck, Panagiotis Fistouris, Christian Fung, Benedikt Haupt, Mukesch Shah, Isaac Josh Abecassis, Dale Ding, Robert F. James · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.3151 · 被引用次数：26 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Acute Ischemic Stroke Management、Traumatic Brain Injury and Neurovascular Disturbances

Importance: It remains uncertain whether surgical evacuation improves functional outcomes in patients with supratentorial intracerebral hemorrhage (ICH). Objective: To compare the safety and efficacy of minimally invasive surgery with the Artemis Neuro Evacuation Device to guideline-based medical management alone for spontaneous supratentorial ICH. Design, Setting, and Participants: The MIND open-label, multicenter randomized clinical trial randomized patients with spontaneous supratentorial ICH in a 2:1 ratio to either minimally invasive surgery or medical management alone. Participants were enrolled at 32 participating global sites between February 6, 2018, and August 28, 2023. This article reports on the primary trial outcome. Of 4066 eligible adult patients (aged 18-80 years) with moderate- to large-volume supratentorial ICH (20-80 mL), baseline National Institutes of Health Stroke Scale score of 6 or higher, and Glasgow Coma Scale score between 5 and 15, 154 were randomized to minimally invasive surgery and 82 to medical management. Data were analyzed from February to September 2024. Intervention: Minimally invasive surgery (within 72 hours of symptom onset) plus medical management or medical management alone. Main Outcomes and Measures: The primary efficacy outcome was 180-day combined death and disability via ordinal modified Rankin Scale score (range, 0 [no symptoms] to 6 [death]). The primary safety outcome was 30-day mortality. Results: Following an independent feas...