ArticleFrontiers in neuroscience2021
Multimodal Simulation of a Novel Device for a Safe and Effective External Ventricular Drain Placement.
Article in Frontiers in neuroscience, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 27 citations in OpenAlex.
- Comparing augmented reality-assisted and freehand external ventricular drain placement: a multicenter randomized controlled crossover phantom study.Acta neurochirurgica · 2025Trial
- History of medical education in neurosurgical training: moving from illustrations and cadaver dissections to virtual simulation.Annals of medicine and surgery (2012) · 2025Review
- A Low-Cost Articulated Arm Navigation System for External Ventricular Drain Placement.IEEE transactions on medical robotics and bionics · 2025Article
- High-Accuracy Augmented Reality Guidance for Intracranial Drain Placement Using a Standalone Head-Worn Navigation System: First-in-Human Results.Neurosurgery · 2025Article
- Assessing the impact of mixed reality-assisted informed consent: A study protocol.Surgical neurology international · 2024Article
- Augmented reality-assisted craniofacial reconstruction in skull base lesions - an innovative technique for single-step resection and cranioplasty in neurosurgery.Neurosurgical review · 2022Article
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Authors and funding
20 authors at 10 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExternal ventricular drain (EVD) placement is mandatory for several pathologies. The misplacement rate of the EVD varies widely in literature, ranging from 12.3 to 60%. The purpose of this simulation study is to provide preliminary data about the possibility of increasing the safety of one of the most common life-saving procedures in neurosurgery by testing a new device for EVD placement.
methodsWe used a novel guide for positioning the ventricular catheter (patent RM2014A000376). The trajectory was assessed using 25 anonymized head CT scans. The data sets were used to conduct three-dimensional computer-based and combined navigation and augmented reality-based simulations using plaster models. The data set inclusion criteria were volumetric head CT scan, without midline shift, of patients older than 18. Evans' index was used to quantify the ventricle's size. We excluded patients with slit ventricles, midline shift, skull fractures, or complex skull malformations. The proximal end of the device was tested on the cadaver.
resultsThe cadaveric tests proved that a surgeon could use the device without any external help. The multimodal simulation showed Kakarla grade 1 in all cases but one (grade 2) on both sides, after right and left EVD placement. The mean Evans' index was 0.28. The geometric principles that explain the device's efficacy can be summarized by studying the properties of circumference and chord. The contact occurs, for each section considered, at the extreme points of the chord. Its axis, perpendicular to the plane tangent to the spherical surface at the entry point, corresponds to the direction of entry of the catheter guided by the instrument.
conclusionAccording to our multimodal simulation on cadavers, 3D computer-based simulation, 3D plaster modeling, 3D neuronavigation, and augmented reality, the device promises to offer safer and effective EVD placement. Further validation in future clinical studies is recommended.
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