Step-by-step placement of endovascular electroencephalography using the EP-01 system

Area of Science:

• Neurology
• Medical Devices
• Interventional Neuroradiology

Background:

• Endovascular electroencephalography (eEEG) requires precise electrode placement for accurate neurological monitoring.
• The EP-01 electrode necessitates reliable venous access and secure fixation for stable positioning during eEEG procedures.

Purpose of the Study:

• To describe a standardized workflow for the placement of the EP-01 electrode for eEEG.
• To detail preprocedural planning, deployment techniques, and fixation strategies for EP-01 electrodes.

Main Methods:

• Utilized venous-phase angiography and 3D MRI for preprocedural venous anatomy assessment.
• Performed EP-01 electrode placement under general anesthesia via jugular venous sheaths with angiographic guidance.
• Secured electrodes using Tuohy-Borst fixation and skin-level dressings post-deployment.

Main Results:

• Successfully completed 12 consecutive EP-01 placements with no procedure-related complications.
• Mean procedure time was 165.6 minutes; mean fluoroscopy time was 51.8 minutes.
• Electrodes were placed with a median dwell time of 2 days, with alternative venous routes used when necessary.

Conclusions:

• A standardized workflow enables feasible and safe EP-01 electrode placement for eEEG.
• Thorough preprocedural assessment of venous anatomy is crucial for successful implantation and may require alternative access strategies.