ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurotrauma
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1634030
This article is part of the Research TopicIntegrative Approaches to Acute Brain Injury: Vascular, Electrical, and Metabolic InteractionsView all 7 articles
Flexible and Adjustable Transparent Sheath Endoport combine with "two-in-one" neuroendoscopic for Minimally Invasive Evacuation of Irregular Intracerebral Hemorrhage
Provisionally accepted
- 1Renmin Hospital of Wuhan University, Wuhan, China
- 2Xiantao First People's Hospital of Yangtze University, Xiantao, China
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Objective: Irregular intracerebral hematomas (ICH), characterized by complex shapes or multi-regional involvement, pose challenges for traditional neuroendoscopy due to rigid endoport limitations. We introduce a Flexible and Adjustable Transparent Sheath Endoport (FATSE) combined with a "two-in-one" neuroendoscopic technique (stereotactic aspiration plus endoscopic evacuation) to address these challenges.In 54 patients with irregular ICH (multi-regional, intraventricular, or widthto-length ratio <50% on CT), we evaluated the FATSE approach. Patients were stratified into four groups by hematoma location: basal ganglia, lobar, thalamic, or intraventricular.The mean hematoma evacuation rate was 95.0% (range 94.0-98.3%), with lobar/intraventricular hemorrhages (Group B) achieving the highest rate (95.2%). Median Glasgow Coma Scale (GCS) score improved by 5.2 points (7.2 to 12.4). There was 0% mortality, 1.9% rebleeding, and 5.6% pneumonia rates. The adjustable sheath enabled 360°cavity inspection in all cases.The FATSE technique offers superior evacuation rates (95.0% vs. 85-90% with rigid endoports) and improved outcomes for irregular ICH, representing a paradigm shift in minimally invasive.
Keywords: intracerebral hemorrhage (ICH), Irregular hematoma, Neuroendoscopy, Flexible and Adjustable Transparent Sheath, Two-in-one technique, minimally invasive surgery, Hematoma evacuation, stereotactic aspiration
Received: 23 May 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Shafiq, Wang, Zhou, Zhiyang, Ping, Zhang and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiang Cai, Renmin Hospital of Wuhan University, Wuhan, China
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