Application of Robotic Stereotactic Assistance (ROSA) for spontaneous intracerebral hematoma aspiration and thrombolytic catheter placement.
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
Series/Report No.
Journal of the Formosan Medical Association
ISSN
0929-6646
Date Issued
2024-06-11
Author(s)
Luh, Hui-Tzung
Zhu, Chunran
Lo, Wei-Lun
Liu, Heng-Wei
Su, Yu-Kai
Su, I-Chang
Lin, Chien-Min
Lin, Ming-Chin
DOI
10.1016/j.jfma.2024.05.018
Abstract
Background: Spontaneous intracerebral hemorrhage (ICH) accounts for up to 20% of all strokes and results in 40% mortality at 30 days. Although conservative medical management is still the standard treatment for ICH patients with small hematoma, patients with residual hematoma ≤15 mL after surgery are associated with better functional outcomes and survival rates. This study reported our clinical experience with using Robotic Stereotactic Assistance (ROSA) as a safe and effective approach for stereotactic ICH aspiration and intra-clot catheter placement.
Methods: A retrospective analysis was conducted of patients with spontaneous ICH who underwent ROSA-guided ICH aspiration surgery. ROSA-guided ICH surgical techniques, an aspiration and intra-clot catheter placement protocol, and a specific operative workflow (pre-operative protocol, intraoperative procedure and postoperative management) were employed to aspirate ICH using the ROSA One Brain, and appropriate follow-up care was provided.
Results: From September 14, 2021 to May 4, 2022, a total of 7 patients were included in the study. Based on our workflow design, ROSA-guided stereotactic ICH aspiration effectively aspirated more than 50% of hematoma volume (or more than 30 mL for massive hematomas), thereby reducing the residual hematoma to less than 15 mL. The mean operative time of entire surgical procedure was 1.3 ± 0.3 h, with very little perioperative blood loss and no perioperative complications. No patients required catheter replacement and all patients' functional status improved.
Conclusions: Within our clinical practice ROSA-guided ICH aspiration, using our established protocol and workflow, was safe and effective for reducing hematoma volume, with positive functional outcomes.
Subjects
ICH aspiration
Intra-clot thrombolysis
ROSA
Robotic stereotactic assistance
Spontaneous intracerebral hemorrhage
Publisher
Elsevier B.V.
Type
journal article