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Freehand External Ventricular Drain (EVD) InsertionGlobally, the incidence of brain disorders and injuries is on the rise. Conditions such as ischemic stroke, intracerebral hemorrhage, traumatic brain injury, and bacterial meningitis are becoming increasingly prevalent. These conditions often require neurosurgical intervention, including the placement of external ventricular drains (EVDs) to manage intracranial pressure.
Currently, freehand techniques using anatomical landmarks have a variable success rate as low as 40%, requiring multiple catheter passes. Additionally, existing devices are cumbersome, non-adjustable, require a large incision, and have a tendency to allow catheter migration following placement. Insertion of an external ventricular drain (EVD) is arguably one of the most common and most important lifesaving procedures encountered, yet it is still performed blind and using a freehand technique |
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Catheter misplacement rate with freehand techniques |
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Inaccuracy
With a catheter misplacement rate as high as 40%, inccuracy impacts patient outcomes. Patients are at increased risk of hemorrhage, infection, delayed CSF draining, increased intracranial pressure and death.
Current freehand techniques have the following effects:
Increased RiskA 1.4 to 3 passes to procedure ratio - multiple catheter passes and added time leads to unnecessary brain insult or vascular injuries |
Additional CareA patient with an EVD-associated infection, will spend 5.2– 13 additional days in intensive care with an EVD in place |
Increased SpendingThis extended intensive care can cause patient to incur an additional $22,360 - $55,900 in costs, making it highly expensive |
