{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:28Z","timestamp":1786125088181,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T00:00:00Z","timestamp":1535673600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Freehand ventricular catheter placement has been reported to have poor accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To investigate whether preoperative computational simulation using diagnostic images improves the accuracy of ventricular catheter placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study included 113 consecutive patients with normal-pressure hydrocephalus (NPH), who underwent ventriculoperitoneal shunting via a parieto-occipital approach. The locations of the ventricular catheter placement in the last 48 patients with preoperative virtual simulation on the 3-dimensional workstation were compared with those in the initial 65 patients without simulation. Catheter locations were classified into 3 categories: optimal, suboptimal, and poor placements. Additionally, slip angles were measured between the ventricular catheter and optimal direction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>All patients with preoperative simulations had optimally placed ventricular catheters; the mean slip angle for this group was 2.8\u00b0. Among the 65 patients without simulations, 46 (70.8%) had optimal placement, whereas 10 (15.4%) and 9 (13.8%) had suboptimal and poor placements, respectively; the mean slip angle for the nonsimulation group was 8.6\u00b0. The slip angles for all patients in the preoperative simulation group were within 7\u00b0, whereas those for 31 (47.7%) and 10 (15.4%) patients in the nonsimulation group were within 7\u00b0 and over 14\u00b0, respectively. All patients with preoperative simulations experienced improved symptoms and did not require shunt revision during the follow-up period, whereas 5 patients (7.7%) without preoperative simulations required shunt revisions for different reasons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Preoperative simulation facilitates accurate placement of ventricular catheters via a parieto-occipital approach. Minimally invasive and precise shunt catheter placement is particularly desirable for elderly patients with NPH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy193","type":"journal-article","created":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T05:44:17Z","timestamp":1535694257000},"page":"647-657","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Utility of Preoperative Simulation for Ventricular Catheter Placement via a Parieto-Occipital Approach in Normal-Pressure Hydrocephalus"],"prefix":"10.1227","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-5569","authenticated-orcid":false,"given":"Shigeki","family":"Yamada","sequence":"first","affiliation":[{"name":"Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto, Japan"},{"name":"Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatsune","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto, Japan"},{"name":"Rakuwakai Villa Ilios, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,6]]},"reference":[{"issue":"4","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"222","DOI":"10.2176\/nmc.44.222","article-title":"Clinical guidelines for idiopathic normal pressure hydrocephalus","volume":"44","author":"Ishikawa","year":"2004","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"3 Suppl","key":"bib2-20240909","first-page":"S1","article-title":"Development 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