Drainage, Irrigation, and Fibrinolytic Therapy (DRIFT) for Adult Intraventricular Hemorrhage Using IRRAflow® Self-Irrigating Catheter

Abstract

Intraventricular hemorrhage (IVH) is a devastating neurosurgical condition associated with high rates of morbidity and mortality. It can occur as the result of several pathologies and typically presents with mental status changes, neurologic deficits, seizures, headaches, and decreased Glasgow Coma Scale score. These patients are often treated with placement of an external ventricular drain, which helps decrease the clot burden; however, they commonly clot off leading to multiple exchanges. We present a case in which drainage, irrigation, and fibrinolytic (DRIFT) therapy using IRRAflow® (IRRAS) irrigating catheter was used to treat a patient with severe IVH secondary to aneurysmal subarachnoid hemorrhage.

Keywords: aneurysmal subarachnoid haemorrhage; intraventricular hematoma; medical device technology development and assessment.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2021, Rajjoub et al.

Figures

Figure 1. Initial head CT

Figure 2. Cerebral angiogram demonstrating the A2-3 junction aneurysm

Figure 3. Head CT demonstrating right-sided IRRAflow catheter (red arrow) and left-sided standard catheter (blue arrow)

Figure 4. Head CT following placement of left-sided IRRAflow catheter

Arrows indicate catheter tips

Figure 5. Head CT following removal of right-sided IRRAflow

Arrow indicates left IRRAflow catheter tip

Figure 6. Head CT following ventriculoperitoneal shunt placement

Arrow indicates the tip of the shunt catheter