Minimally Invasive Surgery Shows Short-Term Promise for Intracerebral Hemorrhage; Long-Term Benefit Is Unclear

Arthur AS, Jahromi BS, Saphier PS, et al. Minimally Invasive Surgery vs Medical Management Alone for Intracerebral Hemorrhage: The MIND Randomized Clinical Trial. JAMA Neurol. 2025; in press.

As part of the MIND open-label, multicenter randomized clinical trial, researchers from 32 participating global sites randomized patients with spontaneous supratentorial intracerebral hemorrhages (ICHs) to either minimally invasive surgery (MIS) using the Artemis Neuro Evacuation Device or medical management (MM) alone.

Although the trial stopped early, given the positive results of a contemporaneous trial and the outcome of a subsequent feasibility analysis, data were available on 236 patients. The median patient age was age 60, the majority of patients (63%) were male, and the majority (70%) had primary deep bleeds. 

The analysis on these patients showed that MIS significantly improved 30-day disability and reduced the occurrence of 180-day serious adverse events; however, MIS did not improve 180-day disability or reduce 30-day mortality compared to guideline-based medical management.

The researchers wrote: “Based on this positive exploratory evidence, a compelling argument can be made for further study of MIS in supratentorial ICH.”