Intracranial catheter insertion guided by wearable mixed reality holograms: A preliminary study

Abstract

Objective To preliminarily evaluate the feasibility and reliability of wearable mixed reality holograms in guiding the intracranial catheter insertion. Methods A total of 25 consecutive patients undergoing emergent intracranial catheter insertion at Department of Neurosurgery, Xuanwu Hospital, Capital Medical University between July 2017 and January 2018 were prospectively enrolled into Group A (18 external ventricular drain, 6 intracranial hematoma aspiration and 1 brain abscess puncture). Other 25 consecutive patients who underwent the same operation between February 2017 and July 2017 were retrospectively enrolled into Group B (20 external ventricular drain, 4 intracranial hematoma aspiration and 1 brain abscess puncture). According to the planned depth and trajectory orientation, catheter insertion under the three-dimensional holographic guidance of a head-mounted device was applied in Group A. Group B underwent the operation based on the classical localizing method. Total operation time, number of insertions and target deviation distance were compared between the 2 groups. Results All patients in Group A achieved holographic guided catheter insertion with an average operation time of 63.2±10.6 min, which was 38.1 ± 12.5 min longer than that in Group B. The mean number of insertions was 1.2 ± 0.2 in Group A and 2.8 ± 0.8 in Group B. The average target deviation in Group A was 4.5 ± 1.7 mm and 13.5 ± 5.9 mm in Group B. Those differences were all statistically significant (P<0.01). None of the patients in Group A had adverse events associated with transcranial puncture catheterization with wearable mixed reality holographic guidance, and 2 (8%) cases of puncture tract hematoma were found after puncture in Group B patients. Conclusion This study has preliminarily verified the feasibility and reliability of wearable mixed reality holographic guidance technique for the procedure of intracranial catheter insertion. Further reduction of its operation time is expected. Key words: Brain diseases; Punctures; Mixed reality; Holograms