OBJECTIVE The authors designed a low-profile device for reliable ventricular access and prospectively studied its safety, efficacy, and accuracy at a large academic center. METHODS A novel device for ventricular entry, the Device for Intraventricular Entry (DIVE) guide, was designed and created by the first and senior authors. Fifty patients undergoing external ventricular drainage (EVD) or shunt placement were prospectively enrolled for DIVE-assisted catheter placement at a single academic center. The primary outcome was the catheter tip location on postprocedural CT. Secondary outcomes included number of catheter passes, clinically significant hemorrhages, and procedure-related infections. RESULTS Fifty patients were enrolled. Indications included subarachnoid hemorrhage, intraventricular hemorrhage, traumatic brain injury, hydrocephalus, pseudotumor, and postsurgical wound drainage. In total, 76% (38/50) of patients underwent right-sided placement and 24% (12/50) underwent left-sided placement. All 100% (50/50) of patients had successful cannulation with an average of 1.06 passes. Postprocedural head CT confirmed ipsilateral frontal horn or third ventricle placement (Kakarla grade 1) in 92% (46/50) of patients and placement in the contralateral lateral ventricle in 8% (4/50) (Kakarla grade 2). There were no clinically significant track hemorrhages or procedural infections. CONCLUSIONS This single-center prospective study investigated the safety and efficacy of DIVE-assisted ventricular access. In total, 100% of procedures had successful ventricular cannulation, with 92% achieving Kakarla grade 1, with an average of 1.06 passes without any clinical complications.

中文翻译：

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脑室内进入装置指南：解决永久性问题的新颖解决方案。

目的 作者设计了一种用于可靠进入心室的低调装置，并在大型学术中心前瞻性研究了其安全性、有效性和准确性。方法 一种新型脑室进入装置，即脑室内进入装置 (DIVE) 导板，由第一作者和资深作者设计和创建。50 名接受脑室外引流 (EVD) 或分流器放置的患者前瞻性地入组在单个学术中心进行 DIVE 辅助导管放置。主要结果是术后 CT 上的导管尖端位置。次要结局包括导管通过次数、临床显着出血和手术相关感染。结果 纳入了 50 名患者。适应症包括蛛网膜下腔出血、脑室内出血、脑外伤、脑积水、假瘤和术后伤口引流。总共，76% (38/50) 的患者接受右侧置入，24% (12/50) 的患者接受左侧置入。所有 100% (50/50) 的患者均成功插管，平均插管次数为 1.06 次。术后头部 CT 证实 92% (46/50) 的患者位于同侧额角或第三脑室 (Kakarla 1 级)，8% (4/50) 的患者位于对侧侧脑室 (Kakarla 2 级)。没有出现临床上显着的径迹出血或手术感染。结论 这项单中心前瞻性研究调查了 DIVE 辅助心室通路的安全性和有效性。总体而言，100% 的手术成功进行了心室插管，其中 92% 达到 Kakarla 1 级，平均 1.06 次通过，没有任何临床并发症。