Accuracy of ultrasound-guided puncture of the ventricular system

Objects Puncture of the ventricular system as one of the most frequently performed operative procedures in neurosurgery is usually done in a freehand way without guiding devices. The objective of this study is to examine whether ultrasonic guidance is able to heighten the accuracy of ventricular tapping. Methods Real-time imaging via a single burr hole approach is achieved by aid of a bajonet-like shaped transducer with a footprint of 8x8 mm only (EUP-NS32, Hitachi Medical Systems). The needle is advanced towards the frontal horn along a displayed guideline. 51 punctures in 48 patients were performed with ultrasonic guidance and compared to 85 punctures in 67 patients without a guiding device. Conclusion The presented ultrasound method was not able to heighten the access rate of ventricular tapping, but it improved correct positioning of the catheter tip inside the frontal horn of the ventricular system significantly.