Feasibility of a Patient-Specific Digital Twin for Ventriculoperitoneal Shunt Trajectory Planning
Abstract
Catheter obstruction is the commonest cause of shunt failure; freehand insertion at Keen's point leaves the tip free in cerebrospinal fluid in only one case in ten. We built a digital twin that reconstructs skull, scalp, ear and ventricles from preoperative CT by deterministic geometry, searches every entry around Keen's point for the perpendicular trajectory with the longest intraventricular length under safety constraints, and returns the plan as two ruler measurements from the ear and two depths. Executed freehand in 11 consecutive adults (IDEAL Stage 2a), it achieved Hayhurst Grade 1 placement in 10 of 11 against 22 of 213 historically (p = 9 x 10^-9), median entry and angular deviations 2.5 mm and 5.9 degrees, 1.4 cm more intraventricular catheter than Keen's point, and no intraoperative complication. The technique was unchanged; the gain came from choosing entry and depth per patient. Whether it lowers revision is the next stage's hypothesis.
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BibTeX
@misc{chongsrid2026feasibility,
title = {{Feasibility of a Patient-Specific Digital Twin for Ventriculoperitoneal Shunt Trajectory Planning}},
author = {Kritsanavis Chongsrid and Vich Yindeedej and Supaporn Konmun and Xulei Yang and Si Yong Yeo},
howpublished = {arXiv},
year = {2026},
month = oct,
doi = {10.48550/arxiv.2610.20074},
eprint = {2610.20074},
archivePrefix = {arXiv},
url = {https://arxiv.org/abs/2610.20074},
}
RIS
TY - UNPB
TI - Feasibility of a Patient-Specific Digital Twin for Ventriculoperitoneal Shunt Trajectory Planning
AU - Kritsanavis Chongsrid
AU - Vich Yindeedej
AU - Supaporn Konmun
AU - Xulei Yang
AU - Si Yong Yeo
PY - 2026
DA - 2026/10/14
PB - arXiv
DO - 10.48550/arxiv.2610.20074
UR - https://arxiv.org/abs/2610.20074
AB - Catheter obstruction is the commonest cause of shunt failure; freehand insertion at Keen's point leaves the tip free in cerebrospinal fluid in only one case in ten. We built a digital twin that reconstructs skull, scalp, ear and ventricles from preoperative CT by deterministic geometry, searches every entry around Keen's point for the perpendicular trajectory with the longest intraventricular length under safety constraints, and returns the plan as two ruler measurements from the ear and two depths. Executed freehand in 11 consecutive adults (IDEAL Stage 2a), it achieved Hayhurst Grade 1 placement in 10 of 11 against 22 of 213 historically (p = 9 x 10^-9), median entry and angular deviations 2.5 mm and 5.9 degrees, 1.4 cm more intraventricular catheter than Keen's point, and no intraoperative complication. The technique was unchanged; the gain came from choosing entry and depth per patient. Whether it lowers revision is the next stage's hypothesis.
ER -