Real-world outcomes and prognostic factors of minimally invasive thrombolytic and soft-channel drainage assisted by 3D Slicer for basal ganglia hemorrhage

BACKGROUND: The integration of 3D Slicer-assisted minimally invasive thrombolysis with soft-channel drainage has shown promise as a treatment strategy for basal ganglia hemorrhage (BGH). This study aimed to evaluate clinical efficacy and identify prognostic‑associated factors in patients. METHODS: We retrospectively analyzed the clinical data of 96 patients with spontaneous BGH. The Glasgow Coma Scale (GCS) score was assessed preoperatively and at the 6-month follow-up, during which functional status was also evaluated using the modified Rankin Scale (mRS). Independent risk factors for an unfavorable prognosis were identified using logistic regression analysis. RESULTS: Surgical outcomes showed a median operative time of 23 minutes, a median hospital stay of 26 days, and a median postoperative day‑3 hematoma clearance rate of 85.53%. The GCS and mRS scores improved significantly at the 6‑month follow‑up (P < 0.001), with 58.33% of patients achieving favorable outcomes. Lower preoperative GCS score, larger hematoma volume, significant compression of the lateral ventricle, thalamic involvement, and longer onset-to-surgery interval were independent risk factors (P < 0.05). CONCLUSIONS: Minimally invasive thrombolytic therapy combined with soft-channel drainage, assisted by 3D Slicer, is feasible and well-tolerated in patients with BGH. Dynamic evaluation of prognostic factors may help optimize clinical management and guide individual therapeutic strategies.