Accuracy of freehand external ventricular drain placement in patients after a large decompressive hemicraniectomy
| Autor: | Carlos Candanedo, Iddo Paldor, Semira Mollica, Eyal Itshayek, Cezar Jose Mizrahi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Decompressive Craniectomy Catheters Intracranial catheter medicine.medical_treatment Catheterization Ventriculostomy Cohort Studies 03 medical and health sciences 0302 clinical medicine Midline shift Physiology (medical) medicine Humans In patient Aged Retrospective Studies Decompressive hemicraniectomy business.industry Retrospective cohort study General Medicine Middle Aged Catheter Neurology 030220 oncology & carcinogenesis Drainage Surgery Decompressive craniectomy Female Neurology (clinical) business Nuclear medicine 030217 neurology & neurosurgery External ventricular drain |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 81 |
| ISSN: | 1532-2653 |
| Popis: | Our study aim is to evaluate the accuracy of freehand external ventricular drain (EVD) placement, without the use of adjuncts to placement, immediately following a large decompressive hemicraniectomy (DC). We performed a retrospective cohort analysis comparing patients who underwent freehand EVD placement immediately after a DC, to those who underwent freehand EVD placement without DC. Computed tomography (CT) studies were used to assess accuracy based on catheter tip location. Intracranial catheter length, pre- and post-operative Evan’s Index, and midline shift pre- and post-operatively were analysed as separate variables in each group. A previously described grading system was used to assess the accuracy of free hand EVD placement. There were a total 110 patients overall; DC group, n = 50; non-DC group, n = 60. There was a significant reduction from pre-operative midline shift to post-operative midline shift in the DC group (9.13 vs 6.02 mm; p = 0.0064). There was no significant difference in accuracy between the two groups (p = 0.8917), and similar rates of Grade 1 – i.e. optimal – catheter tip location (DC = 78% vs non-DC = 81%) were found. All analysed variables comparing both Grade 1 subgroups (pre- and postoperative Evan’s Index, and midline shift) showed significant differences between them. Mean catheter length in Grade 1 EVD placement showed a statistically significant difference between the DC and non-DC groups (63.78 vs 59.96 mm, respectively; p = 0.009). An EVD, after DC for traumatic and non-traumatic intracranial pathologies, can be accurately placed by freehand. |
| Databáze: | OpenAIRE |
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