INTRODUCTION: The present study aimed to compare hematoma evacuation efficiency between multipoint and single-point aspiration techniques, and to investigate the influence of distinct aspiration techniques on functional outcomes in patients undergoing stereotactic catheter aspiration for intracerebral hemorrhage (ICH). METHODS: Clinical and imaging data from 102 consecutive patients diagnosed with ICH who underwent stereotactic catheter aspiration and thrombolysis were collected. Multivariate regression analyses were performed to evaluate the effects of catheter aspiration techniques on residual hematoma volume after aspiration alone (post-aspiration volume), residual hematoma volume at the end of treatment (EOT volume), and functional independence at 6 months (modified Rankin Scale score ≤ 2). RESULTS: The median post-aspiration volume of the multipoint group (n = 52) was 11.9 mL, significantly smaller than 19.8 mL of the single-point group (n = 50
p <
0.002). The multipoint group was administered fewer urokinase doses and had a higher rate of achieving functional independence, although no statistical significance was observed in the univariate analyses. Linear regression analyses revealed that the multipoint aspiration technique was independently associated with lower post-aspiration (p <
0.002) and EOT (p = 0.016) volumes. After controlling for group differences and disease severity variables, binary regression analyses identified multipoint aspiration as an independent factor favoring functional independence 6 months after ICH (p = 0.042). CONCLUSION: Compared with the single-point technique, the multipoint aspiration technique significantly increased immediate hematoma reduction through aspiration alone and independently contributed to a lower EOT volume, which may favor 6-month functional independence in individuals who experience ICH.