Depth-adjustable fixation of external ventricular drains to counteract obstruction in tight ventricles

Tightness of the lateral ventricle may result in mechanical obstruction of an external ventricular drain (EVD). We propose a modified EVD fixation method that allows retraction of the EVD to reopen the drainage. We used this technique in patients requiring long-term EVD placement in the frontal horn who were expected to develop tightening of the ventricle. We placed a catheter fixation device consisting of a dialysis catheter with a catheter-holding wing and a fixture spring. The wing is placed on the EVD just distal to its exit and tied down, and the fixture spring is attached to the wing to secure the EVD. If EVD obstruction associated with tightening of the ventricle was suspected, we removed the spring and retracted the EVD to the depth required for cerebrospinal fluid drainage, then replaced the spring. Retraction by 5-12 mm (mean 8.7 mm) resulted in opening of 8 of the 10 obstructed EVD devices. We encountered no major procedure-related complications. This modified EVD fixation method facilitates depth adjustments for reopening the obstructed drain.