Frameless, electromagnetic image-guided ventriculostomy for ventriculoperitoneal shunt and Ommaya reservoir placement.
OBJECTIVE
Catheter ventriculostomy is a common neurosurgical procedure for placement of Ommaya reservoirs or ventriculo-peritoneal shunts (VPS). Malpositioning or multiple attempts at catheter placement may lead to complications such as hemorrhage, mechanical obstruction, or tissue injury. Traditional navigation systems to guide placement require head fixation, which can lead to additional risks of pin placement as well as inconvenience, particularly with regard to patient positioning. Here we report our experience using frameless, electromagnetic (EM) image-guidance as a fast and low risk method of ensuring accurate ventriculostomy catheter placement.


METHODS
51 consecutive patients with frameless, EM image-guided Ommaya or VPS placement from 2011 to 2015.


METHODS
We retrospectively reviewed patient charts and recorded case duration and patient post-operative outcomes.


RESULTS
Twenty-four (24) patients received Ommayas and 27 received VPS. Average time of operative room set up was 48min. Average case duration was 35min for Ommaya cases and 61min for VPS cases. All catheters were placed with one pass. One patient required revision surgery for obstruction or misplacement. No clinically significant hemorrhages occurred postoperatively.


CONCLUSIONS
Ventriculostomy with EM image-guidance is a safe and efficient way to ensure proper catheter placement and minimize patient complications.
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: lindawxu@stanford.edu.
Linda W
LW
Xu
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
Eric S
ES
Sussman
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
Gordon
G
Li
D000328:Adult; D004574:Electromagnetic Fields; D006801:Humans; D038361:Neuronavigation / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt / Q000379:methods*; D014696:Ventriculostomy / Q000379:methods*
Electromagnetic image-guidance; Ommaya reservoir; Ventriculoperitoneal shunt