Accuracy of ultrasound-guided puncture of the ventricular system

Strowitzkí, Martin; Komenda, Y.; Eymann, Regina; Steudel, Wolf-Ingo

doi:10.1007/s00381-007-0410-x

Cited by 23 publications

(15 citation statements)

References 31 publications

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“…14,15,19,20,31,32 The frontal approach has the shortest intracerebral route 15 with more consistent anatomical landmarks. 15,33,34 However, ventricular catheter shortening and burr hole displacement with growth is more pronounced with this approach. 18,19 In addition, there are aesthetic issues due to the need to shave the scalp in the frontal area.…”

Section: Predictors Of Optimal Shunt Placementmentioning

confidence: 97%

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Factors affecting the accuracy of ventricular catheter placement

Wan

Toy

Wolfe

et al. 2011

Journal of Clinical Neuroscience

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Section: Predictors Of Optimal Shunt Placementmentioning

confidence: 97%

“…34,37 Direct visualization of the catheter is not possible with freehand placement, which is associated with difficulty in gauging optimum catheter length and angle. 2,25,31 As a result, accurate catheter placement can be a challenge, especially in patients with small or abnormal ventricular anatomy.…”

Section: Future Directionsmentioning

confidence: 99%

Factors affecting the accuracy of ventricular catheter placement

Wan

Toy

Wolfe

et al. 2011

Journal of Clinical Neuroscience

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“…In the literature, at least two systems [8,9] for placement of ventricular catheters based on real-time 2D ultrasound imaging have been presented. Real-time imaging is clearly one of the main advantages of ultrasound imaging in general.…”

Section: Discussionmentioning

confidence: 99%

“…A number of groups have described systems based on 2D real-time ultrasound imaging. Strowitzki et al [8] presented a system where a specially designed catheter adapter was attached to the ultrasound probe in order to maintain the catheter in the image plane throughout the procedure. Whitehead et al [9] also described a system for catheter placement based on real-time 2D ultrasound imaging through an enlarged burr hole.…”

Section: Introductionmentioning

confidence: 99%

A new system for 3D ultrasound-guided placement of cerebral ventricle catheters

et al. 2011

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“…42 To date, ultrasound-image assisted ventricular catheter placement has predominantly occurred in the intraoperative setting. 1,3,7,17,32,34,[37][38][39] Early placement attempts using ultrasound imaging were limited to transfontanelle techniques or cases requiring removal of cranial bone to accommodate transducer placement over the brain parenchyma. 12,30,34,37 Contemporary high-resolution ultrasound imaging technology has been refined, allowing smaller transducers to fit within the bur hole alongside the cath- eter.…”

Section: Comparison With Existing Technology and Device Limitationsmentioning

confidence: 99%

Ultrasound stylet for non-image-guided ventricular catheterization

Coulson¹,

Chiarelli

et al. 2015

PED

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OBJECT Urgent ventriculostomy placement can be a lifesaving procedure in the setting of hydrocephalus or elevated intracranial pressure. While external ventricular drain (EVD) insertion is common, there remains a high rate of suboptimal drain placement. Here, the authors seek to demonstrate the feasibility of an ultrasound-based guidance system that can be inserted into an existing EVD catheter to provide a linear ultrasound trace that guides the user toward the ventricle. METHODS The ultrasound stylet was constructed as a thin metal tube, with dimensions equivalent to standard catheter stylets, bearing a single-element, ceramic ultrasound transducer at the tip. Ultrasound backscatter signals from the porcine ventricle were processed by custom electronics to offer real-time information about ventricular location relative to the catheter. Data collected from the prototype device were compared with reference measurements obtained using standard clinical ultrasound imaging. RESULTS A study of porcine ventricular catheterization using the experimental device yielded a high rate of successful catheter placement after a single pass (10 of 12 trials), despite the small size of pig ventricles and the lack of prior instruction on porcine ventricular architecture. A characteristic double-peak signal was identified, which originated from ultrasound reflections off of the near and far ventricular walls. Ventricular dimensions, as obtained from the width between peaks, were in agreement with standard ultrasound reference measurements (p < 0.05). Furthermore, linear ultrasound backscatter data permitted in situ measurement of the stylet distance to the ventricular wall (p < 0.05), which assisted in catheter guidance. CONCLUSIONS The authors have demonstrated the ability of the prototype ultrasound stylet to guide ventricular access in the porcine brain. The alternative design of the device makes it potentially easy to integrate into the standard workflow for bedside EVD placement. The availability of a fast, easy-to-use, inexpensive guidance system can play a role in reducing the complication rate for EVD placement.

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Accuracy of ultrasound-guided puncture of the ventricular system

Abstract: The presented ultrasound method was not able to heighten the access rate of ventricular tapping, but it improved correct positioning of the catheter tip inside the frontal horn of the ventricular system significantly.

Cited by 23 publications

References 31 publications

Factors affecting the accuracy of ventricular catheter placement

Factors affecting the accuracy of ventricular catheter placement

A new system for 3D ultrasound-guided placement of cerebral ventricle catheters

Ultrasound stylet for non-image-guided ventricular catheterization

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