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Updated: Sep 20, 2025
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Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
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Risk factors for complications in bolt-connected external ventricular drains
Raquel Gutiérrez-González1,2, Teresa Mediavilla3, Celia Ortega-Angulo4
1Department of Neurosurgery, Puerta de Hierro University Hospital, IDIPHISA, Majadahonda-Madrid, Spain. rgutierrezgonzalez@yahoo.es.
Neurologia I Neurochirurgia Polska
|May 30, 2025
Summary
This study identified key risk factors for complications from bolt-connected external ventricular drains (EVDs). Prolonged drain duration, CSF leaks, and obstruction increase infection risk, while thicker catheters and anticoagulants raise hemorrhage risk.
Area of Science:
- Neurosurgery
- Medical Device Safety
- Infectious Disease Prevention
Background:
- Bolt-connected external ventricular drains (EVDs) are crucial for managing intracranial pressure.
- Identifying complications associated with EVDs is essential for patient safety and optimizing treatment outcomes.
Purpose of the Study:
- To identify independent risk factors for major complications following bolt-connected EVD insertion.
- To inform targeted preventive strategies for EVD-related adverse events.
Main Methods:
- A single-centre cohort study analyzed 119 patients undergoing bolt-connected EVD placement.
- Complications including infection, hemorrhage, misplacement, obstruction, and pull-out were assessed.
- Univariable and Cox regression multivariate analyses were performed to determine risk factors.
Main Results:
- Ventricular drain duration, CSF leak, and obstruction independently predicted infection.
- Thicker catheters and antiplatelet/anticoagulant use were risk factors for hemorrhage.
- Male gender increased accidental pull-out risk; drain replacement was linked to removal, misplacement, and obstruction.
Conclusions:
- Confirmed risk factors for EVD infection, hemorrhage, and pull-out, enabling targeted prevention.
- Obstruction, misplacement, and accidental removal are significant predictors for requiring new drain placement.
- Surgeon experience and ICU placement did not increase complication risks.
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