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VENTRICULAR CATHETER PLACEMENT WITH A FRAMELESS NEURONAVIGATIONAL SYSTEM: A 1‐YEAR EXPERIENCE

OBJECTIVE Accurate placement of ventricular catheters decreases the incidence of proximal catheter failure. The use of a frameless, interactive neuronavigational system can optimize catheter placement. METHODS Thirty-four ventricular catheters were placed using a Medtronic electromagnetic frameless neuronavigational system (Medtronic Navigation, Inc., Louisville, CO) during a 12-month period. The patients ranged in age from 11 months to 79 years; the mean age was 40.8 years. Nineteen male and 12 female patients participated in the study. The indications for ventricular catheter placement included obstructive hydrocephalus, normal pressure hydrocephalus, pseudotumor cerebri, intrathecal therapy, and tumor cyst aspiration. RESULTS No proximal failures have been reported to date. One infection necessitated shunt removal. Three postoperative deaths occurred because of non-catheter-related events. CONCLUSION Frameless neuronavigation in the placement of ventricular catheters assures accurate catheter placement, thereby decreasing the incidence of proximal catheter failure. The absence of rigid head fixation allows additional cohorts to benefit from the apparatus. The use of the electromagnetic system provides a safe, simple, and easy adjunct to optimal catheter placement.