scholarly journals Development and validation of a rapidly deployable CT-guided stereotactic system for external ventricular drainage: preclinical study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abhijeet S. Barath ◽  
Aaron E. Rusheen ◽  
Juan M. Rojas Cabrera ◽  
Hojin Shin ◽  
Charles D. Blaha ◽  
...  
Keyword(s):  
Time Frame ◽  
External Ventricular Drainage ◽  
Preclinical Study ◽  
Catheter Placement ◽  
High Rate ◽  
Ventricular Drainage ◽  
Ct Guided ◽  
Preclinical Trial ◽  
Stereotactic System ◽  
3D Printed

AbstractExternal ventricular drainage (EVD) is an emergency neurosurgical procedure to decrease intracranial pressure through a catheter mediated drainage of cerebrospinal fluid. Most EVD catheters are placed using free hands without direct visualization of the target and catheter trajectory, leading to a high rate of complications- hemorrhage, brain injury and suboptimal catheter placement. Use of stereotactic systems can prevent these complications. However, they have found limited application for this procedure due to their long set-up time and expensive hardware. Therefore, we have developed and pre-clinically validated a novel 3D printed stereotactic system for rapid and accurate implantation of EVD catheters. Its mechanical and imaging accuracies were found to be at par with clinical stereotactic systems. Preclinical trial in human cadaver specimens revealed improved targeting accuracy achieved within an acceptable time frame compared to the free hand technique. CT angiography emulated using cadaver specimen with radio-opaque vascular contrast showed vessel free catheter trajectory. This could potentially translate to reduced hemorrhage rate. Thus, our 3D printed stereotactic system offers the potential to improve the accuracy and safety of EVD catheter placement for patients without significantly increasing the procedure time.

Accuracy of external ventricular drainage catheter placement

2011 ◽  
Vol 154 (1) ◽  
pp. 153-159 ◽  
Author(s):  
Mohammad Ghazi Abdoh ◽  
Olivier Bekaert ◽  
Jérôme Hodel ◽  
Salia Mamadou Diarra ◽  
Caroline Le Guerinel ◽  
...  
Keyword(s):  
External Ventricular Drainage ◽  
Catheter Placement ◽  
Ventricular Drainage ◽  
Drainage Catheter

scholarly journals The High-Rate Sealed MRPC to Promote Pollutant Exchange in Gas Gaps: Status on the Development and Observations

2021 ◽  
Vol 11 (11) ◽  
pp. 4722
Author(s):  
Botan Wang ◽  
Xiaolong Chen ◽  
Yi Wang ◽  
Dong Han ◽  
Baohong Guo ◽  
...  
Keyword(s):  
Gas Flow ◽  
High Rate ◽  
Stable Operation ◽  
Beam Test ◽  
High Luminosity ◽  
Rate Test ◽  
3D Printed ◽  
Resistive Plate Chambers ◽  
The Impact ◽  
Current Behavior

This work reports the latest observations on the behavior of two Multigap Resistive Plate Chambers (MRPC) under wide high-luminosity exposures, which motivate the development and in-beam test of the sealed MRPC prototype assembled with low-resistive glass. The operation currently being monitored, together with previous simulation results, shows the impact of gas pollution caused by avalanches in gas gaps, and the necessity to shrink the gas-streaming volume. With the lateral edge of the detector sealed by a 3D-printed frame, a reduced gas-streaming volume of ~170 mL has been achieved for a direct gas flow to the active area. A high-rate test of the sealed MRPC prototype shows that, ensuring a 97% efficiency and 70 ps time resolution, the sealed design results in a stable operation current behavior at a counting rate of 3–5 kHz/cm2. The sealed MRPC will become a potential solution for future high luminosity applications.

scholarly journals Intracranial Pressure during External Ventricular Drainage Weaning Is an Outcome Predictor of Traumatic Brain Injury

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jia-cheng Gu ◽  
Hong Wu ◽  
Xing-zhao Chen ◽  
Jun-feng Feng ◽  
Guo-yi Gao ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
External Ventricular Drainage ◽  
Unfavorable Outcome ◽  
Ventricular Drainage ◽  
Outcome Group ◽  
Significant Difference ◽  
The Mean ◽  
The Relationship

External ventricular drainage (EVD) is widely used in patients with a traumatic brain injury (TBI). However, the EVD weaning trial protocol varies and insufficient studies focus on the intracranial pressure (ICP) during the weaning trial. We aimed to establish the relationship between ICP during an EVD weaning trial and the outcomes of TBI. We enrolled 37 patients with a TBI with an EVD from July 2018 to September 2019. Among them, 26 were allocated to the favorable outcome group and 11 to the unfavorable outcome group (death, post-traumatic hydrocephalus, persistent vegetative state, and severe disability). Groups were well matched for sex, pupil reactivity, admission Glasgow Coma Scale score, Marshall computed tomography score, modified Fisher score, intraventricular hemorrhage, EVD days, cerebrospinal fluid output before the weaning trial, and the complications. Before and during the weaning trial, we recorded the ICP at 1-hour intervals to calculate the mean ICP, delta ICP, and ICP burden, which was defined as the area under the ICP curve. There were significant between-group differences in the age, surgery types, and intensive care unit days (p=0.045, p=0.028, and p=0.004, respectively). During the weaning trial, 28 (75.7%) patients had an increased ICP. Although there was no significant difference in the mean ICP before and during the weaning trial, the delta ICP was higher in the unfavorable outcome group (p=0.001). Moreover, patients who experienced death and hydrocephalus had a higher ICP burden, which was above 20 mmHg (p=0.016). Receiver operating characteristic analyses demonstrated the predictive ability of these variables (area under the curve AUC=0.818 [p=0.002] for delta ICP and AUC=0.758 [p=0.038] for ICP burden>20 mmHg). ICP elevation is common during EVD weaning trials in patients with TBI. ICP-related parameters, including delta ICP and ICP burden, are significant outcome predictors. There is a need for larger prospective studies to further explore the relationship between ICP during EVD weaning trials and TBI outcomes.

EARLY TREATMENT OF POST-HEMORRHAGIC VENTRICULAR DILATATION OF THE NEWBORN WITH LONG-TERM EXTERNAL VENTRICULAR DRAINAGE.

1994 ◽  
Vol 22 (s1) ◽  
pp. 185-186
Author(s):  
M.L. Massone ◽  
A. Cama ◽  
V.F. Puccio ◽  
G. Montobbio ◽  
M. Soliani ◽  
...  
Keyword(s):  
Early Treatment ◽  
External Ventricular Drainage ◽  
Ventricular Dilatation ◽  
Ventricular Drainage

scholarly journals SURG-02. INITIAL MANAGEMENT OF HYDROCEPHALUS IN THE PEDIATRIC AND YOUNG-ADULT PATIENTS WITH BRAIN TUMORS; THE EFFICACY OF LONG-TERM INDWELLING EXTERNAL VENTRICULAR DRAINAGE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii461-iii461
Author(s):  
Shigeru Yamaguchi ◽  
Hiroaki Motegi ◽  
Yukitomo Ishi ◽  
Michinari Okamoto ◽  
Akihiro Iguchi ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Young Adult ◽  
Brain Tumors ◽  
External Ventricular Drainage ◽  
The Body ◽  
Ventricular Drainage ◽  
Initial Management ◽  
Effective Option ◽  
Csf Diversion

Abstract BACKGROUND Pediatric and Young-Adult (AYA) brain tumors often present with hydrocephalus. As temporary cerebrospinal fluid (CSF) diversion procedure, we perform long-term indwelling external ventricular drainage (EVD) in the case of the management of CSF diversion more than two weeks presumably. The aim of this study is to investigate the initial management for hydrocephalus in pediatric /AYA patients with brain tumor, especially about long-term EVD. MATERIALS AND METHODS The patients less than 30 years of age diagnosed with brain tumor between 2005 and 2019 were retrospectively analyzed. Procedures of long-term EVD were similar to that of ventriculoperitoneal shunt (VPS) operation. Using flow-control VPS system, peritoneal catheter passed out of the body at the anterior chest, and distal end of the catheter was connected to standard EVD system. RESULTS In total of 345 patients with brain tumor, 109 had hydrocephalus at presentation. Among them, 25 patients (23%) underwent long-term EVD. The main reasons for selecting long-term EVD were to avoid intraperitoneal dissemination (n=13), and to maintain longer period of CSF diversion for the treatment of tumor (n=12). The median of long-term EVD was 38 days (range: 12 – 222 days). Although one case suffered from drainage tube occlusion at 59 days, there were no other complications such as infection or accidental evulsion. Eventually, 3 cases required permanent VPS for persistent hydrocephalus. CONCLUSION Long-term EVD is safe and effective option for CSF diversion. This procedure should be taken into consideration if patients have a risk of dissemination and may elude permanent VPS.

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