Accuracy and Safety of Ventriculostomy Using Two Different Procedures of External Ventricular Drainage: A Single-Center Series

Schuss, Patrick; Wispel, Christian; Borger, Valeri; Güresir, Ági; Vatter, Hartmut; Güresir, Erdem

doi:10.1055/s-0037-1606544

Cited by 12 publications

(1 citation statement)

References 24 publications

(42 reference statements)

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“…These landmarks are mainly Kocher's point, medial epicanthus or midpupillary line, and the external acoustic meatus [2][3][4]. Recently, multiple studies have reported relevant rates of malpositioned freehand EVDs between 3 and 60%, resulting in revision or reinsertion procedures in up to half of these cases [1,20,27]. Intracranial hemorrhage, CSF infections, and neurological deficits are additional complications that may be caused by EVD misplacement with either multiple puncture attempts or need of revision [13,18].…”

Section: Introductionmentioning

confidence: 99%

Navigated bedside implantation of external ventricular drains with mobile health guidance: technical note and case series

Sargut,

Thomale,

Schulz

et al. 2024

Acta Neurochir

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Purpose External ventricular drain (EVD) implantation is one of the fundamental procedures of emergency neurosurgery usually performed freehand at bedside or in the operating room using anatomical landmarks. However, this technique is frequently associated with malpositioning leading to complications or dysfunction. Here, we describe a novel navigated bedside EVD insertion technique, which is evaluated in a clinical case series with the aim of safety, accuracy, and efficiency in neurosurgical emergency settings. Methods From 2021 to 2022, a mobile health–assisted navigation instrument (Thomale Guide, Christoph Miethke, Potsdam, Germany) was used alongside a battery-powered single-use drill (Phasor Health, Houston, USA) for bedside EVD placement in representative neurosurgical pathologies in emergency situations requiring ventricular cerebrospinal fluid (CSF) relief and intracranial pressure (ICP) monitoring. Results In all 12 patients (8 female and 4 male), navigated bedside EVDs were placed around the foramen of Monro at the first ventriculostomy attempt. The most frequent indication was aneurysmal subarachnoid hemorrhage. Mean operating time was 25.8 ± 15.0 min. None of the EVDs had to be revised due to malpositioning or dysfunction. Two EVDs were converted into a ventriculoperitoneal shunt. Drainage volume was 41.3 ± 37.1 ml per day in mean. Mean length of stay of an EVD was 6.25 ± 2.8 days. Complications included one postoperative subdural hematoma and cerebrospinal fluid infection, respectively. Conclusion Combining a mobile health–assisted navigation instrument with a battery-powered drill and an appropriate ventricular catheter may enable and enhance safety, accuracy, and efficiency in bedside EVD implantation in various pathologies of emergency neurosurgery without adding relevant efforts.

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Section: Introductionmentioning

confidence: 99%

Navigated bedside implantation of external ventricular drains with mobile health guidance: technical note and case series

Sargut,

Thomale,

Schulz

et al. 2024

Acta Neurochir

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Elevated C-reactive protein and white blood cell count at admission predict functional outcome after non-aneurysmal subarachnoid hemorrhage

et al. 2018

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Ventriculostomy with subsequent ventriculoperitoneal shunt placement after subarachnoid hemorrhage: the effect of implantation site on postoperative complications—a single-center series

et al. 2020

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Accuracy and Safety of Ventriculostomy Using Two Different Procedures of External Ventricular Drainage: A Single-Center Series

Abstract: The present data indicate that PNT has a similar safety profile in emergency situations in critically ill patients who need immediate treatment for acute hydrocephalus when compared with the conventional EVD procedure.

Cited by 12 publications

References 24 publications

Navigated bedside implantation of external ventricular drains with mobile health guidance: technical note and case series

Navigated bedside implantation of external ventricular drains with mobile health guidance: technical note and case series

Elevated C-reactive protein and white blood cell count at admission predict functional outcome after non-aneurysmal subarachnoid hemorrhage

Ventriculostomy with subsequent ventriculoperitoneal shunt placement after subarachnoid hemorrhage: the effect of implantation site on postoperative complications—a single-center series

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