PT  - JOURNAL ARTICLE
AU  - Theo Demerath
AU  - Amin Stanicki
AU  - Roland Roelz
AU  - Mateo Tomas Farina Nunez
AU  - Marco Bissolo
AU  - Christine Steiert
AU  - Panagiotis Fistouris
AU  - Volker Arnd Coenen
AU  - Horst Urbach
AU  - Christian Fung
AU  - Jürgen Beck
AU  - Peter Christoph Reinacher
TI  - Accuracy of augmented reality-guided drainage versus stereotactic and conventional puncture in an intracerebral hemorrhage phantom model
AID  - 10.1136/neurintsurg-2022-018678
DP  - 2022 Jul 19
TA  - Journal of NeuroInterventional Surgery
PG  - neurintsurg-2022-018678
4099  - http://jnis.bmj.com/content/early/2022/07/19/neurintsurg-2022-018678.short
4100  - http://jnis.bmj.com/content/early/2022/07/19/neurintsurg-2022-018678.full
AB  - Background Minimally invasive intracranial drain placement is a common neurosurgical emergency procedure in patients with intracerebral hemorrhage (ICH). We aimed to retrospectively investigate the accuracy of conventional freehand (bedside) hemorrhage drain placement and to prospectively compare the accuracy of augmented/mixed reality-guided (AR) versus frame-based stereotaxy-guided (STX) and freehand drain placement in a phantom model.Methods A retrospective, single-center analysis evaluated the accuracy of drain placement in 73 consecutive ICH with a visual rating of postinterventional CT data. In a head phantom with a simulated deep ICH, five neurosurgeons performed four punctures for each technique: STX, AR, and the freehand technique. The Euclidean distance to the target point and the lateral deviation of the achieved trajectory from the planned trajectory at target point level were compared between the three methods.Results Analysis of the clinical cases revealed an optimal drainage position in only 46/73 (63%). Correction of the drain was necessary in 23/73 cases (32%). In the phantom study, accuracy of AR was significantly higher than the freehand method (P<0.001 for both Euclidean and lateral distances). The Euclidean distance using AR (median 3 mm) was close to that using STX (median 1.95 mm; P=0.023).Conclusions We demonstrated that the accuracy of the freehand technique was low and that subsequent position correction was common. In a phantom model, AR drainage placement was significantly more precise than the freehand method. AR has great potential to increase precision of emergency intracranial punctures in a bedside setting.All data relevant to the study are included in the article or uploaded as supplementary information. ‘Not applicable’.