Work

Feasibility of a Patient-Specific Digital Twin for Ventriculoperitoneal Shunt Trajectory Planning

Year: 2026

Type: preprint

Abstract: Catheter obstruction is the commonest cause of shunt failure; freehand insertion at Keen's point leaves the tip free in cerebrospinal fluid in only one case in ten. We built a digital twin that reconstructs skull, scalp, ear and ventricles from preoperative CT by deterministic geometry, searches every entry around Keen's point for the perpendicular trajectory with the longest intraventricular length under safety constraints, and returns the plan as two ruler measurements from the ear and two depths. Executed freehand in 11 consecutive adults (IDEAL Stage 2a), it achieved Hayhurst Grade 1 placement in 10 of 11 against 22 of 213 historically (p = 9 x 10^-9), median entry and angular deviations 2.5 mm and 5.9 degrees, 1.4 cm more intraventricular catheter than Keen's point, and no intraoperative complication. The technique was unchanged; the gain came from choosing entry and depth per patient. Whether it lowers revision is the next stage's hypothesis.

Source: arXiv (Cornell University)

DOI: 10.48550/arxiv.2610.20074

Authors: Chongsrid, Kritsanavis, Yindeedej, Vich, Konmun, Supaporn, Yang, Xulei, Yeo, Si Yong

Institutions: Agency for Science, Technology and Research, Thammasat University Hospital, Institute of Advanced Intelligence and Computing

Language: English

Topic: Cerebrospinal fluid and hydrocephalus

Subfield: Clinical Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7221857064

Cites: 3

Cited by:

Related to: 10