Introduction: ICH is associated with the poorest long-term outcomes of any stroke subtype, emphasizing the need for effective treatments. The MIND study evaluated the safety and effectiveness of MIS with Artemis Neuro Evacuation Device and medical management (MM) compared to MM alone.
Methods: The MIND study evaluated the safety and effectiveness of MIS with Artemis Neuro Evacuation Device and medical management (MM) compared to MM alone.
Results: Given the positive ENRICH results and following an independent feasibility analysis, study enrollment was stopped early. Out of 236 enrolled participants, 70.8% had deep ICH. Patients with deep ICH were younger (age 57 vs 69), less likely to be female (31.7 vs 48.6%), had more severe symptoms (NIHSS 19 vs 16; GCS 11 vs 13), and had more co-morbidities than patients with lobar ICHs. Deep ICHs were smaller (35cc vs 50cc). Following MIS, ICH volume was reduced by 81.5% to 6.0cc in the deep and 80.4% to 8.1cc in the lobar cohorts. MIS consistently increased the odds of favorable clinical outcome (ordinal mRS) at 30 days but not at 90 and 180 days. Overall, 30-day mortality was comparable following MIS (6.7% in deep vs. 8.3% in lobar); however, the rates in MM patients varied by location (5.0% vs. 22.7%, respectively). Deep and lobar cohorts had similar utility-weighted mRS, rates of conversion to craniotomy, and serious adverse events rates.
Conclusion : Despite a robust functional benefit at 30 days, MIS did not improve outcomes through 180 days. MIS was successful in achieving substantial hemorrhage reduction and was not associated with excess peri-procedural mortality or adverse events. Further investigation of MIS in ICH is warranted.
.jpg)
