caa a22 4500 606216863 CHVBK 20210128101105.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00701-015-2543-0 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2543-0 Contemporary frameless intracranial biopsy techniques: Might variation in safety and efficacy be expected? [Elektronische Daten] [Iris Verploegh, Victor Volovici, Iain Haitsma, Joost Schouten, Clemens Dirven, Johan Kros, Ruben Dammers] Background: Frameless stereotactic neuronavigation has proven to be a feasible technology to acquire brain biopsies with good accuracy and little morbidity and mortality. New systems are constantly introduced into the neurosurgical armamentarium, although few studies have actually evaluated and compared the diagnostic yield, morbidity, and mortality of various manufacturer's frameless neuronavigation systems. The present study reports our experience with brain biopsy procedures performed using both the Medtronic Stealth TreonTM Vertek® and BrainLAB® Varioguide frameless stereotactic brain biopsy systems. Patients and methods: All 247 consecutive biopsies from January 2008 until May 2013 were evaluated retrospectively. One hundred two biopsies each were performed using the Medtronic (2008-2009) and BrainLAB® system (2011-2013), respectively. The year 2010 was considered a transition year, in which 43 biopsies were performed with either system. Patient demographics, perioperative characteristics, and histological diagnosis were reviewed, and a comparison was made between the two brain biopsy systems. Results: The overall diagnostic yield was 94.6%, i.e., 11 biopsies were nondiagnostic, 5 (4.9%) with the Medtronic and 6 (5.9%) with the BrainLAB® system. No differences besides the operating time (108 vs 120min) were found between the two biopsy methods. On average, 6.6 tissue samples were taken with either technique. Peri- and postoperative complications were seen in 5.3% and 12.9%, consisting of three symptomatic hemorrhages (1.2%). Biopsy-related mortality occurred in 0.8% of all biopsies. Conclusions: Regarding diagnostic yield, complication rate, and biopsy-related mortality, there seems to be no difference between the frameless biopsy technique from Medtronic and BrainLAB®. In contemporary time, the neurosurgeon has many tools to choose from, all with a relatively fast learning curve and ever improving feasibility. Thus, the issue of choice involves not the results, but the familiarity, end-user friendliness, and overall comfort when operating the system. The Author(s), 2015 Frameless stereotaxy nationallicence Biopsy nationallicence Varioguide nationallicence Stealth nationallicence Brain tumor nationallicence Verploegh Iris Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut Volovici Victor Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut Haitsma Iain Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut Schouten Joost Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut Dirven Clemens Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut Kros Johan Department of Pathology, Brain Tumor Center, Erasmus Medical Center, Rotterdam, The Netherlands aut Dammers Ruben Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 2011-2016 0001-6268 157:11<2011 2015 157 701 https://doi.org/10.1007/s00701-015-2543-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2543-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Verploegh Iris Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut NATIONALLICENCE 700 1- Volovici Victor Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut NATIONALLICENCE 700 1- Haitsma Iain Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut NATIONALLICENCE 700 1- Schouten Joost Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut NATIONALLICENCE 700 1- Dirven Clemens Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut NATIONALLICENCE 700 1- Kros Johan Department of Pathology, Brain Tumor Center, Erasmus Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Dammers Ruben Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, ‘s Gravendijkwal 230, Kamer H-703, 3015, Rotterdam, CE, The Netherlands aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 2011-2016 0001-6268 157:11<2011 2015 157 701