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Updated: May 5, 2026
3D Modeling of the Lateral Ventricles and Histological Characterization of Periventricular Tissue in Humans and Mouse
Published on: May 19, 2015
The vascular safe zone for endoscopic third ventriculostomy: a radiomorphometric study
Nicolás Rincón-Arias1, Nadin J Abdala-Vargas2, Sabino Luzzi3
1Department of Neurosurgery, Fundación Universitaria de Ciencias de la Salud - FUCS, Hospital de San José - Sociedad de Cirugía de Bogotá, Bogotá, Colombia; Department of Neurosurgery, Fundación Universitaria de Ciencias de la Salud - FUCS, Hospital Infantil Universitario de San José, Bogotá, Colombia.
Background And Objective:
Endoscopic third ventriculostomy (ETV) is a minimally invasive procedure for hydrocephalus management. Variable neuroanatomical features in the floor of the third ventricle (3VF) and the basilar artery (BA) complex contribute to the risk of vascular lesions in the BA complex. This study aims to evaluate the neuroradiological characteristics of the 3VF with the BA complex to determine the ETV fenestration "vascular safe zone".
Methods:
Preoperative neuroimaging studies from a consecutive cohort of adult patients who underwent ETV between January 2016 and March 2025 were retrospectively reviewed. Preoperative MRIs were used to evaluate the neuroradiological axial and sagittal characteristics of the 3VF with the BA complex.
Results:
The neuroradiological BA complex position was described. In the sagittal plane, Type II (74 %) was the most common, with mean distances ranging from 4.1 mm to 8 mm. The mean distance from the top of the BA complex to the 3VF was 6.86 mm (SD 1.56 mm). In the axial plane, Classes C and D (71.2 %) were predominant and had varied distances to the 3VF.
Conclusions:
Our results suggest that the "vascular safe zone" for an ETV fenestration is primarily located in the anterior half of the 3VF. 71.2 % of our cases showed that the basilar artery (BA) complex was located in the posterior half. Future research should validate the "vascular safe zone" for ETV fenestration with neuroendoscopy intraoperative observations and assess clinical outcomes, including post-operative complications and success rates, to ensure the effectiveness of the proposed fenestration area.
