Comparative accuracy evaluation of patient-specific 3D-printed guide and neuronavigation for ventriculoperitoneal shunt in dogs: a dual-phase ex vivo and in vivo study.

BACKGROUND

Ventriculoperitoneal shunting (VPS) is an effective treatment for canine hydrocephalus, but complications related to ventricular catheter (VC) misplacement remain a concern. Although neuronavigation improves accuracy, its cost and complexity limit veterinary use. Patient-specific 3D-printed guiding systems (PS-3DGS) offer a potential alternative.

OBJECTIVES

To compare the accuracy and feasibility of PS-3DGS compared to electromagnetic neuronavigation for VC placement in 3D-printed canine cranio-ventricular models (CVMs) and Beagle dogs.

ANIMALS AND STUDY

DESIGN

Ten 3D-printed CVMs (ex vivo study) and five experimental Beagle dogs (in vivo study).

METHODS

VC placement was performed using PS-3DGS and neuronavigation in CVMs and experimental animals. Accuracy was assessed by the distance from the VC tip to the foramen of Monro (DFM), tip coordinates (X, Y, Z axes), tip placement error, intraventricular insertion length (IIL), and catheter contact with the ventricular wall (VVL). Intraoperative procedural time and anatomical variables, including skull and cranial indices, were also analyzed.

RESULTS

PS-3DGS showed no significant difference in DFM compared to neuronavigation in CVMs and Beagle dogs. PS-3DGS achieved significantly lower VVL and reduced procedural time than neuronavigation in the CVM study (p = 0.011 and p = 0.039, respectively). In dogs, DFM with PS-3DGS was comparable to both neuronavigation and the ex vivo results. Entry point error correlated negatively with cranial index (r = -0.9, p = 0.037).

CONCLUSION

PS-3DGS provided accuracy comparable to neuronavigation while simplifying the procedure. It represents a viable, cost-effective alternative for canine VPS surgery, potentially enhancing catheter placement and reducing complications.