• World Neurosurg · Dec 2024

    Electromagnetic Navigation Improves Accuracy and Reduces Complications of Ventriculoperitoneal Shunts in Patients with Idiopathic Normal Pressure Hydrocephalus: A Single-center Clinical Experience.

    • Xudong Ma, Xuehai Fan, Wenqinyi Yang, Jiahe Guo, Ziwei Zhou, Dong Wang, Yimeng Wu, Ningnannan Zhang, Guozhi Song, Yan Xing, Xiuyun Liu, Kai Yu, and Huijie Yu.
    • Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
    • World Neurosurg. 2024 Dec 4; 194: 123428123428.

    BackgroundVentriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compared the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in patients with iNPH, focusing on catheter accuracy and postoperative complication rates.MethodsThis retrospective study included 31 patients with iNPH who underwent standard shunt placement using anatomical landmarks and 50 patients who underwent EM-guided shunt placement. Parameters assessed included shunt placement grade, catheter tip position, catheter angle, puncture attempts, operative duration, postoperative infection rates, intraparenchymal hemorrhage rates, and shunt malfunction rates. Patients had follow-ups at 3, 6, 12, and 24 months after surgery or until shunt failure.ResultsIn the EM-guided group, a higher percentage of grade 1 shunt placements (92% vs. 71%, P = 0.03) and fewer grade 3 placements (2% vs. 13%, P = 0.068) were observed. The catheter tip position at the foramen of Monro was significantly more accurate (P < 0.001), with smaller lateral catheter deviation angles in both coronal (19.69° vs. 24.2°, P < 0.0001) and sagittal (21.75° vs. 39.3°, P < 0.01) sections. The EM-guided group had fewer puncture attempts, shorter operative durations, lower incidence of intraparenchymal hemorrhage (P < 0.01), and fewer shunt malfunctions over the 2-year follow-up period (2% vs. 26%, P = 0.0003).ConclusionsThe use of EM navigation in VP shunt placement for patients with iNPH improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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