• Asgeir S Jakola, Ingerid Reinertsen, Tormod Selbekk, Ole Solheim, Frank Lindseth, Sasha Gulati, and Geirmund Unsgård.
• Department of Neurosurgery, St. Olavs University Hospital, Trondheim; National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; MI Lab, Medical Faculty, Norwegian University of Science and Technology, Trondheim; Department of Neuroscience, Medical Faculty, Norwegian University of Science and Technology, Trondheim. Electronic address: asgeir.s.jakola@ntnu.no.
• World Neurosurg. 2014 Sep 1;82(3-4):536.e5-9.

ObjectiveMany studies demonstrate that the accuracy of freehand catheter placement for cerebrospinal fluid drainage is suboptimal. The aim of placement should be a single pass with a free-floating catheter tip in the intended position. The objective of this study was to achieve an accurate and user-friendly system for three-dimensional (3D) ultrasound-navigated catheter placement through a regular burr hole.MethodsA new phased-array ultrasound burr hole probe (4-10 MHz, 8 mm×9 mm footprint) was especially developed and optimized for navigated 3D ultrasound with the SonoWand Invite system. A catheter holder for optical tracking was also developed. Head immobilization was achieved with a vacuum cushion. With the described setup, 4 patients underwent surgery.ResultsUltrasound image quality and visualization of the ventricles was good in all cases. Optimal placement of the catheter was achieved in a single pass in all patients. One of the trajectories was slightly more medial on postoperative computed tomography than anticipated from the neuronavigation system. None of the patients experienced any adverse event related to the procedure.Conclusions3D ultrasound with the described setup is a promising technique for accurate, fast, and user-friendly navigated placement of catheters for cerebrospinal fluid diversion.Copyright © 2014 Elsevier Inc. All rights reserved.

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