Evidence map›Paper›PMID 40959870›Full record

ArticleStroke2025

Projecting US Population Eligibility for Minimally Invasive Surgical Evacuation of Intracerebral Hemorrhage.

Paul M Wechsler, Heidi Sucharew, David J Robinson, Robert J Stanton, Yasmin N Aziz, Charles Prestigiacomo, Stacie L Demel, Paul Horn, Thomas C Maloney, Brady J Williamson and 16 more

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In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

26 authors.

Paul M WechslerDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-0314-1867
Heidi SucharewDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-3933-1574
David J RobinsonDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0003-3221-3599
Robert J StantonDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0003-3804-5063
Yasmin N AzizDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-3515-4005
Charles PrestigiacomoDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-5979-2378
Stacie L DemelDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-3000-8420
Paul HornDepartment of Pediatrics, Cincinnati Children's Hospital, OH (P.H.).ORCID 0000-0002-4990-5754
Thomas C MaloneyDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).
Brady J WilliamsonDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-1161-402X
Lily WangDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-5107-438X
Vivek J KhandwalaDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-6076-2395
Shantala GangatirkarDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).
Mary Gaskill-ShipleyDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-1398-8308
Mary HaverbuschDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-1017-1036
Thomas TomsickDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).
David WangCapital Radiology, Melbourne, VIC, Australia (D. Wang).
Rebecca S CorneliusDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).
Daniel WooDepartment of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, NY (D. Woo).ORCID 0000-0002-2466-7155
Joseph P BroderickDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-7323-7709
Dawn O KleindorferDepratment of Neurology, University of Michigan, Ann Arbor (D.O.K.).ORCID 0000-0003-1361-3693
Brett M KisselaDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-9773-4013
Matthew L FlahertyDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-6247-010X
Eva A MistryDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0002-7426-3650
Achala VagalDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (P.M.W., H.S., D.J.R., R.J.S., Y.N.A., C.P., S.L.D., T.C.M., B.J.W., L.W., V.J.K., S.G., M.G.-S., M.H., T.T., R.S.C., J.P.B., B.M.K., M.L.F., E.A.M., A.V.).ORCID 0000-0001-6428-6499
Pooja KhatriDepartment of Neurology, Yale University, New Haven, CT (P.K.).ORCID 0000-0002-7344-8266

Funding

Assessing Population-based Radiological brain health in Stroke Epidemiology (APRISE) StudyR01NS103824 · NINDS · UNIVERSITY OF CINCINNATI · PI KHATRI, POOJA, KISSELA, BRETT M · 2018 to 2022
$3.1M
NINDS NIH HHS R01 NS103824
6 · The paper itself

Abstract

backgroundMinimally invasive surgical evacuation improved outcomes for patients with acute, spontaneous, lobar intracerebral hemorrhage (ICH) in the ENRICH trial (Early Minimally Invasive Removal of ICH). We determined the percentage of patients with ICH in a US population-based study eligible for minimally invasive surgical evacuation and projected the annual number of patients with ICH in the United States in 2020 eligible for this therapy.

methodsWe ascertained adults (aged ≥18 years) with acute (<24 hours from last known well), spontaneous ICH in Greater Cincinnati/Northern Kentucky in 2015. Cases were identified by the

resultsWe identified 196 patients in Greater Cincinnati/Northern Kentucky in 2015 with acute, spontaneous ICH. After applying all criteria, 2.0% (n=5) of all patients with acute ICH (5.1%; n=5 lobar ICH) were eligible for minimally invasive surgical evacuation. The most common exclusion criteria were ICH volume <30 mL (60%) and prestroke modified Rankin Scale score >1 (52%). In liberal estimates, 2.6% to 3.6% (n=4-7) of all patients with acute ICH (4.1%-7.1% of lobar ICH) were eligible. We projected 1066 to 1848 patients of an estimated 72 283 adult patients with ICH in the United States in 2020 met eligibility criteria.

conclusionsApproximately 2% to 4% of patients with ICH in our population were eligible for minimally invasive surgical evacuation based on ENRICH criteria, which extrapolates to 1066 to 1848 patients with ICH in the United States annually. Future research is needed to determine whether indications for effective surgical therapy for ICH can be expanded.

Indexed as

Cerebral HemorrhageMinimally Invasive Surgical ProceduresAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedUnited Statesanticoagulantsbraincerebral hemorrhagegeneral surgerystroke

Identifiers

PMID40959870
PMCPMC12453619

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