gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Ventricle catheter placement in children with the new Axiem™ system

Meeting Abstract

  • C. Tschan - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • E. Hermann - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • H.-H. Capelle - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • J. Krauss - Klinik für Neurochirurgie, Medizinische Hochschule Hannover

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP16-04

DOI: 10.3205/09dgnc425, URN: urn:nbn:de:0183-09dgnc4256

Published: May 20, 2009

© 2009 Tschan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: So far common systems for neuronavigated or stereotactic ventricle catheter placement were dependent on sharp fixation of the head within a stereotactic frame or Mayfield clamp. Recently, a new electromagnetic tracking technology has become available, the Axiem™-System, without the need of sharp head fixation.

Methods: Four children (mean age 28 months, range 20-53 months) with hydrocephalus and difficult ventricle anatomy or slit ventricle syndrome underwent neuronavigated ventricle-catheter placement with the new Stealth Station Axiem™-System. The single-coil technology of this system allows the use of flexible instruments; here, the ventricle catheter stylet is to be tracked at the tip.

Results: During the procedure the head was freely movable without loss of navigation precision. The system was not restricted by a camera’s line of sight to the tip-tracked flexible stylet which allowed the visualization of the exact catheter tip localization. The ventricle catheter was exactly placed into the direction to the foramen of Monroe by this method. Intra-operative catheter-placement as documented by screen shot correlated exactly to the postoperative CT-scan. The system was easy to use; the mean operation time was 61 minutes. There were no operative or postoperative complications.

Conclusions: The Axiem™-System is a real innovation for navigated catheter placement, especially in children, as it avoids sharp fixation of the head. This technique should also allow navigated catheter placement in newborn or premature infants.