Trial Comparing Early Minimally Invasive Surgery with Thrombolysis Versus Best Medical Management for Acute Spontaneous Intracerebral Hemorrhage

What this Trial Is About

Researchers are evaluating treatments for adults with acute spontaneous supratentorial intracerebral hemorrhage ICH of 20mL or more. This trial compares early minimally invasive surgery combined with thrombolysis eMIST to best medical management. The goal is to assess which approach improves functional outcomes after stroke, measured by a blinded evaluation at 180 days using the modified Rankin Scale. Participants are randomly assigned to one of two groups one receives minimally invasive catheter evacuation followed by up to 10 doses of urokinase to help dissolve the clot the other group receives standard medical care. The intervention is given early after stroke onset, with randomization within 8 hours and treatment started within 4 hours after randomization. The study uses an adaptive design with ongoing assessment of sample size and outcomes. During the study, participants undergo assessments including brain imaging, functional outcome scales, and quality of life questionnaires at multiple time points up to 180 days. Researchers will monitor clot removal, mortality, daily living activities, and health-related quality of life. The trial includes follow-up visits to evaluate recovery and safety over time, supporting a thorough understanding of treatment effects and participant progress.

TrIal of Early Minimally Invasive Catheter Evacuation With Thrombolysis in IntraCerebral Hemorrhage