title: Anchoring depth electrodes for bedside removal:  a "break-away" suturing technique for intracranial monitoring.
abstract: BACKGROUND
  Intracranial depth electrodes for epilepsy are easily dislodged during long-term monitoring unless adequately anchored, but a technique is not available that is both secure and allows easy explantation without reopening the incision.
  
  
  OBJECTIVE
  To describe a convenient and inexpensive method for anchoring depth electrodes that prevents migration and incidental pullout while allowing electrode removal at the bedside.
  
  
  METHODS
  An easily breakable suture (eg, MONOCRYL) is tied around both the depth electrode and a heavy nylon suture and anchored to a hole at the edge of the burr hole; the tails of both are tunneled together percutaneously. The "break-away" MONOCRYL suture effectively anchors the electrode for as long as needed. At the completion of the intracranial electroencephalography session, the 2 tails of the nylon suture are pulled to break their encompassing MONOCRYL anchor suture, thus freeing the depth electrode for easy removal.
  
  
  RESULTS
  The break-away depth electrode anchoring technique was used for 438 electrodes in 68 patients, followed by explantation of these and associated strip electrodes without reopening the incision. Only 1 electrode (0.2%) migrated spontaneously, and 3 depth electrodes (0.7%) fractured in 2 patients (2.9%) on explantation, necessitating open surgery to remove them in 1 of the patients (1.5%).
  
  
  CONCLUSIONS
  An easy and inexpensive anchoring configuration for depth electrodes is described that provides an effective and safe means of securing the electrodes while allowing easy explantation at the bedside.
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. rgross@emory.edu
authors.forename: Robert E
authors.initials: RE
authors.lastname: Gross
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Rowland
authors.forename: Edward K
authors.initials: EK
authors.lastname: Sung
authors.forename: David V
authors.initials: DV
authors.lastname: LaBorde
authors.forename: Shadeah L
authors.initials: SL
authors.lastname: Suleiman
mesh_terms: D004567:Electrodes, Implanted; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000601:surgery; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D013537:Sutures