Purpose: Spontaneous deep supratentorial haemorrhage is associated with high morbidity and mortality. There is limited evidence on surgical treatment possibilities. This study evaluates the effect of acute minimally invasive surgery (MIS) using the Artemis neuro evacuation device versus medical management alone in patients with spontaneous deep intracerebral haemorrhage (ICH).

Methods: Eleven patients with spontaneous ICH who underwent acute endoscopic surgery with the Artemis system were matched 1:1 with nonsurgical patients, resulting in a total of 22 patients in the study.

Results: The 30-day mortality was 18% in the surgical group and 36% in the non-surgical group (RR=0.5; [95%CI = 0.11;2.19]). Overall mortality was 18% for the surgical group and 45% for the non-surgical group (RR=0.4; [95%CI = 0.10;1.64]). The mean modified Rankin Scale score was 3.82 for the surgical group and 4.45 for the non-surgical group (P=0.3761).

Conclusion: Surgery using the Artemis neuro evacuation device showed a tendency to reduce 30-day mortality in patients with spontaneous basal ganglia intracerebral haemorrhage. These results support the need for a randomized controlled trial of MIS using the Artemis system compared to medical management alone.