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  • Stereotactic navigation for external ventricular drain placement in the ICU

    Final Number:

    Mark Mahan MD; Peter Nakaji; Robert F. Spetzler MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: To assess the accuracy of ventriculostomy when performed using image-navigation technology at the bedside

    Methods: 35 patients were consecutively enrolled in a single arm trial evaluating the radiographic accuracy and complications from ventriculostomies performed at the ICU bedside using image guidance technologies.

    Results: There were no unacceptably placed ventriculostomy catheters, and only two catheters not perfectly placed in the ipsilateral frontal horn. There were two registration failures which were converted to traditional technique. There was one case of tract hemorrhage. The use of image-guidance technology added approximately 36 minutes to the time from identified need to successful drainage (p= 0.002) and only 4 minutes of additional operative time (p = 0.12). These results show a statistically significant improvement in the accuracy of ventriculostomy

    Conclusions: Image guidance technology eliminated unacceptably placed catheters and reduced the risk of catheter-associated intracerebral hemorrhages

    Patient Care: Eliminated risk of misplaced EVD catheters and reduced odds of intraparenchymal hemorrhages

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) critically evaluate the use of image guidance in placement of EVDs 2) compare outcomes in relationship to complications 3) consider the value of newer technology in routine practices


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