Mistie Intracerebral Hemorrhage Trial

Intracerebral hemorrhage (ICH) is the only major stroke subtype without a clearly effective treatment. ICH occurs in over 100,000 Americans yearly. African Americans, Hispanics and Asians are disproportionately affected. ICH is fatal in 30 to 50% of all occurrences, while it leaves the majority of survivors with significant motor and cognitive disability.

Previous studies of standard surgery for ICH have not shown any clear benefit. MISTIE is a series of clinical trials where a thin catheter is placed into the hematoma with 3D navigation, followed by injection of thrombolytics over the next few days. Perhaps this minimally invasive, gentler approach can yield better outcomes. The MISTIE-II trial showed that this procedure can shrink the hematoma quickly, effectively and safely. Patients who had the MISTIE surgery had shorter hospital stays and were less likely to end up disabled over the following year.

In September 2013, the US National Institutes of Health funded a larger follow-up study, MISTIE-III. This study will enroll 500 patients from about 100 medical centers around the world. At Montefiore Medical Center this is a multi-disciplinary, collaborative effort led Dr. Rishi Malhotra, Director of Neurocritical Care. Co-investigators include Drs. Adam Keene, Mellanie Springer, David Gordon, David Altschul, and Neil Singh.

If the MISTIE approach proves to be effective in this large-scale clinical trial, it could dramatically change the way ICH is treated throughout the world. Dr. Malhotra believes that Montefiore’s participation in trials like MISTIE provides the community we serve with cutting edge information and approaches in the treatment of stroke. This is particularly critical, given the high incidence of stroke in our patient population. The Stern Stroke Center at Montefiore sees more than 1200 acute stroke patients a year, making it the second busiest stroke center in New York State.

Our participation in trials like MISTIE reinforce Montefiore’s commitment to finding hope in devastating diseases like stroke, that can cost so many people their quality of life, livelihoods and, in some instances, their lives. 

For more information please contact our study coordinators Kristina Kordesch NP or Jesse Lora at MISTIE@montefiore.org or 718-920-2956. For time-sensitive questions regarding MISTIE please page us at 917-956-0444.