{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:49:13Z","timestamp":1785898153027,"version":"3.56.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Minimally invasive surgery (MIS) for spontaneous supratentorial intracerebral hemorrhage (sICH) includes endoscopic evacuation and catheter-based evacuation (aspiration or drainage\u2009\u00b1\u2009thrombolysis), but comparative performance remains uncertain. We performed a systematic review and meta-analysis comparing MIS approaches. PubMed, Embase, and CENTRAL were searched (December 2025) for studies in adults undergoing endoscopic or catheter-based MIS for supratentorial sICH. Random-effects meta-analysis was conducted. Prespecified subgroup analyses stratified catheter-based techniques by thrombolysis use. Risk of bias and certainty of evidence was assessed. Twenty-nine studies (8221 patients; 5041 endoscopic; 3180 catheter-based) were included. Endoscopic evacuation was associated with lower mortality (RR 0.64; 95% CI: 0.47\u20130.87;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.01;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200944.8%), rebleeding (RR 0.58; 95% CI: 0.39\u20130.87;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.01;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200922.2%), postoperative hematoma volume (MD -5.6\u00a0mL; 95% CI: -10.30\u20130.90;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200996.9%), and higher day-one evacuation rate (MD 24.5%; 95% CI: 14.60\u201334.40;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200999.7%). Overall complications (RR 0.98; 95% CI: 0.78\u20131.25;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.90;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200948.5%) and infection (RR 1.03; 95% CI: 0.64\u20131.66;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.05;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200943.6%) were similar. Catheter-based approaches had lower intraoperative blood loss (MD 69.0\u00a0mL; 95% CI: 27.7\u2013110.4;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200996.9%). Subgroup analyses suggested that mortality and evacuation rate differences favored catheter-based cohorts receiving thrombolysis. Functional outcomes diverged: GCS\/GOS favored endoscopy (SMD 0.27) while mRS marginally favored catheter-based approaches (MD 0.28), a between-group difference below the threshold generally considered clinically meaningful. Endoscopic evacuation was associated with lower mortality, rebleeding, and residual hematoma burden, while catheter-based approaches retained perioperative efficiency advantages. Functional findings were mixed and of uncertain clinical significance. Given predominantly non-randomized evidence and heterogeneity, these findings should be interpreted as strategy-specific associations.\n                  <\/jats:p>","DOI":"10.1007\/s10143-026-04426-3","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:26:42Z","timestamp":1785896802000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic versus catheter-based minimally invasive evacuation of spontaneous supratentorial intracerebral hemorrhage: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"49","author":[{"given":"Shaan","family":"Patel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva A.","family":"Nischal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kush M.","family":"Kale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelette","family":"Mendonca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keenan","family":"Piper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pious D.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Gooch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavropoula I.","family":"Tjoumakaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal M.","family":"Jabbour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"4426_CR1","doi-asserted-by":"publisher","first-page":"e1985","DOI":"10.1212\/WNL.0000000000207132","volume":"100","author":"YB Abulhasan","year":"2023","unstructured":"Abulhasan YB, Teitelbaum J, Al-Ramadhani K, Morrison KT, Angle MR (2023) Functional outcomes and mortality in patients with intracerebral hemorrhage after intensive medical and surgical support. 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