Official Title: High-accuracy Augmented Reality Guidance for Intracranial Drain Placement Using a Standalone Head-worn Navigation System
Status: COMPLETED
Status Verified Date: 2018-11
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: No
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: ARANED
Brief Summary: The goal of this clinical trial is to learn if high-accuracy augmented reality AR guidance for external ventricular drain EVD placement using a standalone head-worn navigation system can improve current shortcomings of freehand and image-guidance techniques It will assess safety feasibility and clinical performance The main questions it aims to answer are
Is the implementation of a standalone head-worn AR navigation system for EVD placement in critical care settings feasible and safe How does it compare to the conventional freehand technique in terms of EVD placement quality complication rate and revision rate
Researchers will assess placement quality using the modified Kakarla scale grading placement quality based on the position of the EVD tip on postoperative CT imaging The amount of attempts complications and revisions will be documented The results of the AR-guided placements will be compared to a matched non-concurrent freehand control group
Participants will undergo AR-guided EVD placement in a critical care setting ie the emergency room or intensive care unit
Detailed Description: External ventricular drain EVD placement is often performed using the freehand technique In comparison to image-guided methods this technique was identified as the primary risk factor of improper outcome yielding optimal placement in only 70 While conventional image guidance technologies introduce a distinct improvement in accuracy these systems tend to be prohibitively large and lack mobility restricting their use to the operating room As such their practical implementation in critical care settings is not always feasible due to time availability and cost constraints
This study aims to address shortcomings in both conventional EVD placement and current image guidance technologies To achieve this first an AR headset-based navigation system was developed providing high-accuracy inside-out infrared tracking and software features specifically focusing on EVD placement Phantom studies were conducted which proved successful with a positive outcome of AR-guided EVD placement on phantom heads over the freehand technique Given these results the researchers aim to test the system in a clinical trial setting
Given the additional layer of information on top of knowledge and experience regarding the freehand technique it is hypothesized that AR guidance will result in an improved outcome as was the case for conventional neuronavigation
This study is a prospective clinical pilot study with the goal to assess feasibility safety and clinical performance of high-accuracy AR-guided EVD placement using a standalone head-worn navigation system in critical care settings at the Universitair Ziekenhuis Brussel over the course of one year The outcome will be quantified using the modified Kakarla scale to assess EVD placement quality on postoperative CT imaging as well as the amount of attempts complications and revisions The results of the AR-guided placements will be compared to a non-concurrent control group of matched for quantity intervention performing surgeons and timeframe freehand EVD placement cases that will be collected retrospectively
The study protocol was approved by the Ethics Committee of the Universitair Ziekenhuis Brussel ref 2018447 and validated by the Belgian Federal Agency of Medicines and Health Products FAGGAFMPS ref 80M0764