Minimally Invasive Surgery vs Medical Management Alone for Intracerebral Hemorrhage

Can minimally invasive surgery with the Artemis Neuro Evacuation Device improve outcomes in patients with spontaneous supratentorial intracerebral hemorrhage?The MIND randomized clinical trial stopped early, given the positive results of a contemporaneous trial and the outcome of a subsequent feasibility analysis; however, the available data for 236 participants suggest that minimally invasive surgery (within 72 hours of symptom onset) did not improve 180-day disability or reduce 30-day mortality in patients with spontaneous supratentorial intracerebral hemorrhage compared to guideline-based medical management. Minimally invasive surgery significantly improved 30-day disability and reduced the occurrence of 180-day serious adverse events.While MIND did not demonstrate a benefit of minimally invasive surgery over medical management with respect to reducing 180-day disability or 30-day mortality, the Artemis system achieved efficient, safe, and substantial hemorrhage reduction in both deep and lobar bleeds.

Corresponding Author: Adam S. Arthur, MD, MPH, Department of Neurosurgery, Semmes-Murphey Clinic and University of Tennessee Health Sciences Center, 6325 Humphreys Blvd, Memphis, TN 38120 (aarthur@semmes-murphey.com).

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