Percutaneous ventriculostomy - evolution of a device

The technique applied for external ventriculostomy should allow simple, fas t, stable and clean performance of this procedure. The stepwise development of a metallic ventriculostomy kit should help overcome shortcomings of tra ditional methods of external ventriculostomy such as catheter obstruction a nd propensity for infection. A rigid ventriculostomy set for precoronary pu ncture was developed, consisting of a screw with selfbiting conical thread and a cannula with distal holes for CSF drainage. The rate of infection was < 2% in nonseptic patients with a mean duration of the ventriculostomy of 11 days (maximum: 2 months). Hemorrhage occurred in 1% of patients. problem s were secondary wound healing after prolonged periods with ventriculostomy in place and rapid CSF-infection in cases of loosened screws which were no t instantly removed. Ventriculostomy can be performed bedside within 5 min and clotted cannulas can be exchanged via the indwelling screw. The system can be resterilized and the titanium device is MRI-compatible. The method t ested compares favorably with conventional techniques of external ventricul ostomy. Use of the system requires continuous education of the personnel in volved in order to avoid complications such as hemorrhage and loosening of the screw.