Effectiveness of Minimally Invasive Parafascicular Surgery in Intracerebral Hemorrhage: Andrew Russman, DO


The head of the Stroke Program and Medical Director of the Comprehensive Stroke Center at Cleveland Clinic provided perspective on the ENRICH trial, the first positive surgical trial for intracerebral hemorrhage. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"Not every patient is the right candidate. If you look at the results from ENRICH, you’ll see it was driven a bit by lobar hemorrhages–there were more lobar hemorrhages enrolled in that trial. However, we can’t forget that we see extraordinary results in evacuating deep hemorrhages."

Intracerebral hemorrhage (ICH), a bleeding close to the surface or deep areas of the brain, affects more than 2 million individuals each year, with significantly high morbidity and mortality rates. Currently, up to 50% of people die within 30 days of an ICH, highlighting the need for new options. At the 2023 American Academy of Neurology (AAN) Annual Meeting, April 22-27, in Boston, Massachusetts, investigators presented positive data from the ENRICH trial (NCT02880878) showcasing the superiority of NICO Corporation’s technologies to standard of care for ICH.

The randomized, adaptive, clinical trial specifically assessed early minimally invasive parafascicular surgery (MIPS) using NICO’s complete technology solution, which includes the NICO BrainPath and NICO Myriad. In a primary analysis group of 300 patients with spontaneous hemorrhagic stroke, utility-weighted modified Rankin scale (UWmRS) at 180 days was the primary outcome. All told, at the end of the 6-month observation period, the mean UWmRS score was 0.458 in the MIPS group and 0.374 for those who received traditional medical management (MM) based on American Heart Association/American Stroke Association guidelines.

Findings showed that MIPS was safe and overall mortality at 6 months was 21.7% (MIPS: 20%; MM: 23.3%). For more context on the findings, NeurologyLive® sat down with Andrew Russman, DO, head of the Stroke Program and Medical Director of the Comprehensive Stroke Center at Cleveland Clinic who presented the results. Russman spoke on the uniqueness of this trial, the benefits seen from MIPS, and the significance of effectively treating ICH.

Click here for more coverage of AAN 2023.

1. NICO Corporation announces world’s first positive surgical trial for the deadliest type of stroke. News release. April 22, 2023. Accessed April 25, 2023. https://www.prnewswire.com/news-releases/nico-corporation-announces-worlds-first-positive-surgical-trial-for-the-deadliest-type-of-stroke-301804756.html
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