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Published in: Child's Nervous System 1/2013

01-01-2013 | Technical Note

Smartphone-assisted guide for the placement of ventricular catheters

Published in: Child's Nervous System | Issue 1/2013

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Abstract

Objective

Freehand placement of ventricular catheters (VC) is reported to be inaccurate in 10–40 %. Endoscopy, ultrasound, or neuronavigation are used in selected cases with significant technical and time-consuming efforts. We suggest a smartphone-assisted guiding tool for the placement of VC.

Methods

Measurements of relevant parameters in 3D-MRI datasets in a patient cohort with narrow ventricles for a frontal precoronal VC placement were performed. In this context, a guiding tool was developed to apply the respective measures for VC placement. The guiding tool was tested in a phantom followed by CT imaging to quantify placement precision. A smartphone application was designed to assist the relevant measurements. The guide was applied in 35 patients for VC placement.

Results

MRI measurements revealed the rectangular approach in the sagittal plane and the individual angle towards the tangent in the coronal section as relevant parameter for a frontal approach. The latter angle ranged from medial (91.96° ± 2.75°) to lateral margins (99.56° ± 4.14°) of the ventricle, which was similar in laterally shifted (±5 mm) entry points. The subsequently developed guiding tool revealed precision measurements in an agarose model with 1.1° ± 0.7° angle deviation. Using the smartphone-assisted guide in patients with narrow ventricles (frontal occipital horn ratio, 0.38 ± 0.05), a primary puncture of the ventricles was possible in all cases. No VC failure was observed during follow-up (9.1 ± 5.3 months).

Conclusions

VC placement in narrow ventricles requires accurate placement with simple means in an every-case routine. The suggested smartphone-assisted guide meets these criteria. Further data are planned to be collected in a prospective randomized study.
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Metadata
Title
Smartphone-assisted guide for the placement of ventricular catheters
Publication date
01-01-2013
Published in
Child's Nervous System / Issue 1/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-1943-1

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