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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0045-1808074
Letter to the Editor

Catheter Occlusion in External Ventricular Drainage: The “VISTA” Mnemonic

Luis Rafael Moscote-Salazar 
1   Department of Research, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
2   Department of Research, AV Healthcare Innovators, LLC, Madison, Wisconsin, United States
3   Department of Research, International Consortium of Neurological Research, Minneapolis, United States
4   Department of Research, School of Medicine, University of Cartagena, Cartagena, Colombia
,
Ariana Chacon
5   Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, United States
,
Maria Pula Fernandez-Gomez
6   Department of Research, Valerio Latinamerican Foundation, Miami, Florida, United States
,
William Andres Flore Perdomo
1   Department of Research, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
,
Tariq Janjua 
7   Department of Research, Aneuclose, Eagan, Minnesota, United States
,
Amit Agrawal
8   Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
› Author Affiliations Funding None.
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Introduction

External ventricular drains (EVDs) are common in neurocritical care for monitoring and treating intracranial pressure (ICP).[1] Despite their usefulness, occlusion is a well-known and potentially life-threatening complication. Causes of obstruction include intracranial hypotension, coagulated blood, tissue debris, and collapse of the ventricular wall around the catheter ([Table 1]). Early detection and timely intervention are paramount to keeping the catheter useful and avoiding secondary brain injury.

Table 1

Causes of cessation of CSF flow in the EVD

Mechanical

 Kink/disconnection

 Catheter malposition

 Filter occlusion

 Hypotension with collapsed ventricles

Cellular debris

 Blood

 Tissue fragments

 Ventriculitis

Diversion

 CSF leak away from the site of EVD

 Over-drainage

 Decompression on the contralateral side

Abbreviations: CSF, cerebrospinal fluid; EVD, external ventricular drain.




Publication History

Article published online:
21 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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