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.

MISTIE is a series of clinical trials where neurosurgeons and neurologists are trying to quickly remove this blood clot from the brain using a thrombolytic (MISTIE II and MISTIE III) or a CT-guided endoscope (MISTIE-ICES).

Preliminary results from the MISTIE II trial have shown that blood clot in the brain can be successfully removed quickly and safely. These early results also suggest that the MISTIE technique reduces the rate of death and improves the patient's neurologic functioning and quality of life in the year following this type of hemorrhagic stroke. Dr. Daniel F. Hanley, co-principal investigator, presented the phase 2 results at the 2013 International Stroke Conference in Honolulu. The slides are downloadable at the following link. (An editable PowerPoint version is also downloadable by participating clinical sites, after log-in, for use in Grand Round presentations.)

3D CT image of MISTIE treatment dissolving ICHIn September 2013, a phase 3 study, MISTIE III, was funded by the US National Institutes of Health to enroll 500 patients from about 100 medical centers around the world. The MISTIE approach in this large-scale clinical trial could dramatically change the way intracerebral hemorrhage is treated throughout the world.

Lower Doses of Clot-Busting Drug Safer for Stroke Patients (17-Feb-2006)

Researchers Fine-Tune Clot Busting Treatment for Bleeding in Brain (14-May-2008)

Clot-Buster Boosts Survival, Decreases Disability for Deadly Subset of Stroke (19-Feb-2009)

Dr. Hanley discusses MISTIE II results at 2013 International Stroke Conference (07-Feb-2013)

Dr. Hanley's interview with Neurology Reviews on MISTIE II Results (07-Feb-2013)

Medscape: Minimally Invasive Clot Lysing Promising in ICH (08-Feb-2013)

Novel Hemorrhagic Stroke Therapy Bests Medical Management (11-Feb-2013)

Dr. Mario Zucarello, co-principal investigator, remarks on the MISTIE trial (07-Feb-2013)

MedPage: Hematoma attack cuts edema in brain bleed (12-Feb-2013) Identifier:


NIH/NINDS Research Project Cooperative Agreement:

R01 NS046309