Figure 2.

Quality of catheter position was evaluated in different factors. The factors 1 to 3 refer to the primary endpoint analysis combining first, the amount of puncture attempts, second, grading of catheter tip location in relation to paraventricular tissue, and third, anatomical position of the catheter tip. The primary endpoint was defined as an optimal catheter position at first puncture attempt, grade I and ipsilateral ventricle (upper green box). In addition, the incorrect catheter position was defined as ≥2 puncture attempts, grade II and IV, and nonipsilateral catheter position (upper red box). A, Grading scale (for distal 2 cm of catheter): grade I: catheter position without contact of more than 0.5 cm to the ventricular wall; grade II: contact of more than 0.5 cm to the ventricular wall or the choroid plexus; grade III: only partially intraventricular position of the catheter tip (less than 1.5 cm intraventricular); grade IV: extraventricular position of the catheter (less than 0.5 cm intraventricular). B, Anatomical catheter position with the catheter tip position located in the ipsilateral, contralateral, third ventricle, or in the tissue. C, As a secondary endpoint, the rate of complete intraventricular position of the perforated part of the catheter tip was defined. Aside from the complete extraventricular position of the catheter tip, different possible scenarios for perforations being in contact with adjacent brain tissue. That represents either the catheter is positioned too short, too long, has perforated the septum or not is inside the ventricles (iv, intraventricular).