AUTHOR=Huang Xin , Yan Ziwei , Jiang Lai , Chen Shaojun , Liu Yifei 

TITLE=The efficacy of stereotactic minimally invasive thrombolysis at different catheter positions in the treatment of small- and medium-volume basal ganglia hemorrhage (SMITDCP I): a randomized, controlled, and blinded endpoint phase 1 trial

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1131283

DOI=10.3389/fneur.2023.1131283

ISSN=1664-2295

ABSTRACT=Abstract 
Objective To evaluate the effects of stereotactic minimally invasive puncture with different catheter placement positions combined with urokinase thrombolysis in the treatment of small and medium volume basal ganglia hemorrhage, the objective of this experiment is to obtain the best minimally invasive catheter placement position, so as to enhance the treatment effects of patients with cerebral hemorrhage. 
Methods SMITDCPⅠ was a randomized, controlled, endpoint phase 1 experiment. We recruited patients with spontaneous medium to the small and medium volume of basal ganglia hemorrhage who were treated in our hospital. All patients received stereotactic minimally invasive puncture combined with intracavitary thrombolytic injection of urokinase hematoma. Randomized number table method was used to divide the patients into two groups as to the location of catheterization: the penetrating hematoma long axis group and the hematoma center group. The general conditions of the two groups of patients were compared, and the data were counted, including the time of catheterization, the dosage of urokinase, the amount of residual hematoma, the hematoma clearance rate, complications and the NIHSS score data at a month after surgery. The two groups of data were compared and analyzed. 
Results During the period from June 2017 to March 2022, 83 patients were randomly assigned, 42 cases (50.60%) to the penetrating hematoma long axis group, and 41 cases (49.40%) to the hematoma center group. Compared with the the hematoma center group, the long axis group had shorter catheterization time, less urokinase, less residual hematoma, higher hematoma clearance rate and fewer complications (p<0.05). However, there was no significant differences in NIHSS scores between the two groups one month after operation (P>0.05). 
Conclusion Stereotactic minimally invasive puncture combined with urokinase in the treatment of small and medium volume of basal ganglia hemorrhage, catheterization through the long axis of hematoma shows better drainage effects and fewer complications, while the two different catheterization positions do not affect the short-term NIHSS scores.