- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04957849
Acute Hypertensive Cerebral Hemmorrhage Surgery (NET-OCEAN)
July 3, 2021 updated by: Hou Lijun, Shanghai Changzheng Hospital
The Neuroendoscopic, Trans-occipital Approach Evacuation of Acute Hypertensive Cerebral Hemmorrhage Combined Low-drainage Surgery: a Multi-center Clinical Trial
The Neuroendoscopic, Trans-occipital Approach Evacuation of Acute Hypertensive Cerebral Hemmorrhage Combined Low-drainage Surgery: a Multi-center Clinical Trial
Study Overview
Status
Not yet recruiting
Conditions
Detailed Description
To evaluate the effect of different surgical approaches on the prognosis of patients with hypertensive intracerebral hemorrhage, hypertensive patients who met the diagnostic criteria of American guidelines for the treatment of adult spontaneous intracerebral hemorrhage (2015) were selected.
The time from onset to admission was less than 8 hours.
Blood routine examination, liver and kidney function, coagulation system, infectious diseases and other examinations were performed before operation, with emergency surgical indications, They were divided into two groups: transfrontal keyhole approach and transoccipital keyhole approach.
Emergency endoscopic hematoma removal was performed.
The patients were systematically evaluated and followed up at 1 week, 1 month, 3 months, 6 months and 12 months after operation to observe the improvement of consciousness, GCS score, postoperative rebleeding (appearance, bleeding volume, location, broken into ventricle, etc.), The prognosis was evaluated by ADL score, GCS score, gos score, modified Rankin scale, Mrs scale and ICH Score (GCS, hematoma volume, intraventricular hemorrhage, infratentorial source, patient age, etc.).
Study Type
Interventional
Enrollment (Anticipated)
1000
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Lijun Hou, MD,PhD
- Phone Number: 86 21 81885671
- Email: houlijunsmmu@163.com
Study Contact Backup
- Name: Liang Zhao, MD,PhD
- Phone Number: 86 21 81885686
- Email: 15921509289@163.com
Study Locations
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Shanghai
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Shanghai, Shanghai, China, 200003
- Department of Neurosurgery, Shanghai Changzheng Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
15 years to 75 years (Child, Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Diagnosed patients with spontaneous cerebral hemorrhage in the basal ganglia (in line with the diagnostic criteria of the American Adult Spontaneous Cerebral Hemorrhage Treatment Guidelines (2015)).
- Head CT showed; hematoma volume ≥ 30ml, intraventricular hemorrhage is not counted as hemorrhage volume.
- Time from onset to hospital admission ≤8h.
- The age of the patient is 15-75 years old.
- Glasgow Coma Score (GCS)> 5 points.
- The patient/family knows and signs the informed consent form.
- Have a clear history of hypertension in the past.
Exclusion Criteria:
- Bleeding caused by aneurysm, vascular malformation or tumor stroke.
- Combined with a history of head injury or trauma.
- There is more blood in the skull.
- Past mental disorders or neurological dysfunction.
- A history of procoagulant dysfunction or anticoagulant drugs.
- Patients with complications such as liver and kidney dysfunction.
- Those with poor compliance.
- Pregnant patients.
- With massive hemorrhage of the ventricle (the area of the hematoma in the CT side is larger than 1/2 of the transverse section), hemorrhage in the third and fourth ventricles with enlarged ventricles.
- With late-stage cerebral herniation (bilateral dilated pupils, central respiratory and circulatory failure).
- Severe cardiovascular and cerebrovascular diseases: such as myocardial infarction, cerebral infarction, coronary heart disease, myocarditis, malignant arrhythmia, etc.
- Participate in other clinical research 3 months before enrollment.
- The doctor in charge believes that the study plan cannot be followed.
- Those who are or plan to become pregnant or breastfeeding.
- Those who are known to be allergic to test drugs or related products.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Trans-frontal keyhole approach
After general anesthesia, the patient was placed in supine position with head frame fixed.
A straight or arc incision was made in the hairline of the affected side.
The incision was 3cm beside the midline.
The length of the incision was about 4cm and the diameter of the bone window was about 2.5cm.
According to the preoperative thin-layer CT scan, the dura mater and part of the cerebral cortex were cut, and the endoport and other hard channels were inserted.
The incision reached 2 / 3 of the length of the hematoma along the direction parallel to the long axis of the hematoma, During the operation, mini aneurysms were clipped to close the responsible vessels, and hemostatic gauze was applied on the surface of the hematoma cavity.
Silica gel external drainage tube was placed in the hematoma cavity.
The external drainage tube led out the skin through the subcutaneous tunnel, and the dura was sutured.
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Endoscopic Evacuation of Acute Hypertensive Intracerebral Hemorrhage via Trans-frontal keyhole approach
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Active Comparator: Trans-occipital keyhole approach
After general anesthesia, the patient was placed in prone position with head frame fixed.
According to the preoperative thin-layer CT scan, the long axis of hematoma was perpendicular to the ground, and the occipital puncture point was found along the extension line of the long axis of hematoma.
Taking the puncture point as the center, a straight or arc incision parallel to the sagittal sinus was taken.
The length of the incision was about 4cm, and the diameter of the bone window was about 2.5cm, Endoport and other hard channels were inserted to reach 2 / 3 of the long diameter of the hematoma along the direction parallel to the long axis of the hematoma.
Under the neuroendoscope, the hematoma was aspirated or resected in blocks.
During the operation, mini aneurysm clamp was used to clamp the responsible vessels, and hemostatic gauze was applied on the surface of the hematoma cavity.
Silica gel external drainage tube was placed in the hematoma cavity.
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The Neuroendoscopic, Trans-occipital Approach Evacuation of Acute Hypertensive Cerebral Hemmorrhage Combined Low-drainage Surgery
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical remission rate
Time Frame: 1 month postoperation
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The evaluation criteria of complete remission: more than 85% of intracranial hematoma was cleared, mild brain edema, and the postoperative hospital stay was less than 2 weeks.
The evaluation criteria of partial remission: the clearance rate of intracranial hematoma was 60% - 85%, the postoperative brain edema was obvious, and the postoperative hospital stay was less than 4 weeks.
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1 month postoperation
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
January 1, 2022
Primary Completion (Anticipated)
December 31, 2024
Study Completion (Anticipated)
June 30, 2025
Study Registration Dates
First Submitted
July 3, 2021
First Submitted That Met QC Criteria
July 3, 2021
First Posted (Actual)
July 12, 2021
Study Record Updates
Last Update Posted (Actual)
July 12, 2021
Last Update Submitted That Met QC Criteria
July 3, 2021
Last Verified
July 1, 2021
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- NET-OCEAN
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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