Initial multicenter technical experience with the apollo device for minimally invasive intracerebral hematoma evacuation

Alejandro M. Spiotta, David Fiorella, Jan Vargas, Alexander Khalessi, Dan Hoit, Adam Arthur, Jonathan Lena, Aquilla S. Turk, M. Imran Chaudry, Frederick Gutman, Raphael Davis, David A. Chesler, Raymond D. Turner

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

BACKGROUND: No conventional surgical intervention has been shown to improve outcomes for patients with spontaneous intracerebral hemorrhage (ICH) compared with medical management. OBJECTIVE: We report the initial multicenter experience with a novel technique for the minimally invasive evacuation of ICH using the Penumbra Apollo system (Penumbra Inc, Alameda, California). METHODS: Institutional databases were queried to perform a retrospective analysis of all patients who underwent ICH evacuation with the Apollo system from May 2014 to September 2014 at 4 centers (Medical University of South Carolina, Stony Brook University, University of California at San Diego, and Semmes-Murphy Clinic). Cases were performed either in the neurointerventional suite, operating room, or in a hybrid operating room/angiography suite. RESULTS: Twenty-nine patients (15 female; mean age, 62 6 12.6 years) underwent the minimally invasive evacuation of ICH. Six of these parenchymal hemorrhages had an additional intraventricular hemorrhage component. The mean volume of ICH was 45.4 6 30.8 mL, which decreased to 21.8 6 23.6 mL after evacuation (mean, 54.1 6 39.1% reduction; P, .001). Two complications directly attributed to the evacuation attempt were encountered (6.9%). The mortality rate was 13.8% (n = 4). CONCLUSION: Minimally invasive evacuation of ICH and intraventricular hemorrhage can be achieved with the Apollo system. Future work will be required to determine which subset of patients are most likely to benefit from this promising technology.

Original languageEnglish (US)
Pages (from-to)243-251
Number of pages9
JournalOperative Neurosurgery
Volume11
Issue number2
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

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Cerebral Hemorrhage
Hematoma
Equipment and Supplies
Operating Rooms
Hemorrhage
Angiography
Databases
Technology
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Initial multicenter technical experience with the apollo device for minimally invasive intracerebral hematoma evacuation. / Spiotta, Alejandro M.; Fiorella, David; Vargas, Jan; Khalessi, Alexander; Hoit, Dan; Arthur, Adam; Lena, Jonathan; Turk, Aquilla S.; Imran Chaudry, M.; Gutman, Frederick; Davis, Raphael; Chesler, David A.; Turner, Raymond D.

In: Operative Neurosurgery, Vol. 11, No. 2, 01.06.2015, p. 243-251.

Research output: Contribution to journalArticle

Spiotta, AM, Fiorella, D, Vargas, J, Khalessi, A, Hoit, D, Arthur, A, Lena, J, Turk, AS, Imran Chaudry, M, Gutman, F, Davis, R, Chesler, DA & Turner, RD 2015, 'Initial multicenter technical experience with the apollo device for minimally invasive intracerebral hematoma evacuation', Operative Neurosurgery, vol. 11, no. 2, pp. 243-251. https://doi.org/10.1227/NEU.0000000000000698
Spiotta, Alejandro M. ; Fiorella, David ; Vargas, Jan ; Khalessi, Alexander ; Hoit, Dan ; Arthur, Adam ; Lena, Jonathan ; Turk, Aquilla S. ; Imran Chaudry, M. ; Gutman, Frederick ; Davis, Raphael ; Chesler, David A. ; Turner, Raymond D. / Initial multicenter technical experience with the apollo device for minimally invasive intracerebral hematoma evacuation. In: Operative Neurosurgery. 2015 ; Vol. 11, No. 2. pp. 243-251.
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