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RECRUITING
NCT06870812
NA

Rapid Evacuation and Access of Cerebral Hemorrhage Trial

Sponsor: Emory University

View on ClinicalTrials.gov

Summary

The main purpose of this study is to compare patients with a deep bleed in the brain undergoing surgery to patients receiving routine medical care. The standard treatment involves admission to the Intensive Care Unit (ICU) with close monitoring and blood pressure control. It also includes other medical (non-surgical) treatments to prevent more bleeding or another stroke. Sometimes, doctors will recommend surgery to remove the blood if medical treatment alone is not successful. There is evidence that doing minimally invasive surgery early-using a small opening in the skull to remove blood-may help some patients. Researchers aim to understand whether this surgery is better than current medical treatment, which may include surgeries to relieve pressure on the brain in some cases. This study, called REACH, is comparing usual medical care to early minimally invasive surgery so doctors can know which is better for patients.

Key Details

Gender

All

Age Range

18 Years - 70 Years

Study Type

INTERVENTIONAL

Enrollment

600

Start Date

2025-05-27

Completion Date

2030-03

Last Updated

2026-03-19

Healthy Volunteers

No

Interventions

PROCEDURE

Surgical management

Following randomization into the surgical arm, a competency-trained neurosurgeon will perform the MIPS for clot evacuation with strict adherence to the Surgical Manual of the CSG. Image interpretation, patient position, anesthetic plan, stereotactic navigation registration, exoscopic positioning, access, optics, resection, and hemostasis are detailed in the Surgical Manual of the CSG. The OR arrival time should occur \<24 hours from the last known normal (LKN) with a goal of arrival in less than 8 hours from the last known normal.

OTHER

Medical Management

Following randomization into the medical arm patients will be treated following the Medical Manual of the CSG. The Medical Manual has been adapted by the REACH Executive Committee (REC) from the current American Heart Association (AHA) and American Stroke Association (ASA) Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Whenever clinically feasible, the CSG should be followed as it represents a template for the care of these subjects. The Medical Manual details specialty level of care, including intensive care placement, blood pressure control, hemostasis and coagulopathy, anemia, deep venous thrombosis and pulmonary embolism prophylaxis/treatment, glucose management, temperature management, seizure prophylaxis, intracranial pressure monitoring and management, intraventricular hemorrhage (IVH)/obstructive hydrocephalus management, cerebral edema, decompressive hemicraniectomy, nutritional support, respiratory support, and comfort care.

Locations (21)

University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Stanford University Medical Center

Palo Alto, California, United States

Baptist Health Jacksonville FL

Jacksonville, Florida, United States

Baptist Health South Florida

Kendall, Florida, United States

Jackson Memorial Hospital (JMH)

Miami, Florida, United States

Grady Memorial Hospital

Atlanta, Georgia, United States

Emory Hospital Midtown

Atlanta, Georgia, United States

Emory University Hospital (EUH)

Atlanta, Georgia, United States

Rush University

Chicago, Illinois, United States

Endeavor Health, Northshore

Evanston, Illinois, United States

Goodman Campbell Brain and Spine

Carmel, Indiana, United States

University of Kentucky

Lexington, Kentucky, United States

Johns Hopkins School of Medicine

Baltimore, Maryland, United States

University of Missouri

Columbia, Missouri, United States

Albany Medical Center

Albany, New York, United States

SUNY Upstate Medical University

Syracuse, New York, United States

Montefiore Medical Center/Albert Einstein School of Medicine

The Bronx, New York, United States

The Ohio State University

Columbus, Ohio, United States

ProMedica Toledo Hospital

Toledo, Ohio, United States

Rhode Island Hospital/Brown University Health

Providence, Rhode Island, United States

Vanderbilt University Medical Center

Nashville, Tennessee, United States