Evacuate: The New Frontier of ICH Management

A talk by Amal Abou-Hamden on intracerebral haemorrhage (ICH) and the latest developments in the management of this devastating form of stroke, including the ongoing EVACUATE trial, a randomized controlled trial of ultra-early, minimally invasive, haematoma evacuation versus standard care within 8 hours of intracerebral hemorrhage.

This podcast was recorded at the Brain Symposium which took place in March 2023. Scroll down to read a summary of the talk and view the presentation slides.

SUMMARY

A Talk by Amal Abou-Hamden on intracerebral haemorrhage (ICH) and the latest developments in the management of this devastating form of stroke.

Amal discusses what ICH is, and the history of management of surgical management of ICH including the STICH1 and STICH2 trials. She then discusses the ongoing EVACUATE trial, a randomized controlled trial of ultra-early, minimally invasive, haematoma evacuation versus standard care within 8 hours of intracerebral haemorrhage.

The premise is that minimally invasive techniques may improve ICH outcomes by rapid removal of blood from the parenchyma and reducing oedema formation, while also limiting further neuronal damage from the surgical intervention itself. Minimally invasive surgery (MIS) approaches promise to provide these benefits and have become alluring options for management of ICH. Here’s a review on other MIS techniques used in ICH.

The EVACUATE trial is investigating whether the combination of evacuating very quickly, as well as using a minimally invasive technique, will be the combination that makes a difference in the right population of ICH patients. It uses the SCUBA (Stereotactic Intracerebral Haemorrhage Underwater Blood Aspiration) technique – there’s a brief video showing how it works here.