RT Journal Article
SR Electronic
T1 Accuracy of augmented reality-guided drainage versus stereotactic and conventional puncture in an intracerebral hemorrhage phantom model
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2022-018678
DO 10.1136/neurintsurg-2022-018678
A1 Theo Demerath
A1 Amin Stanicki
A1 Roland Roelz
A1 Mateo Tomas Farina Nunez
A1 Marco Bissolo
A1 Christine Steiert
A1 Panagiotis Fistouris
A1 Volker Arnd Coenen
A1 Horst Urbach
A1 Christian Fung
A1 Jürgen Beck
A1 Peter Christoph Reinacher
YR 2022
UL http://jnis.bmj.com/content/early/2022/07/19/neurintsurg-2022-018678.abstract
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’.