Targeting Accuracy of the Leksell Vantage Stereotactic System for Deep Brain Stimulation Surgery: A Retrospective Review.

Background: Compared with the Leksell G frame, the new Leksell Vantage stereotactic headframe offers many benefits during deep brain stimulation (DBS) procedures.

Objective: To define the "real-world" targeting accuracy of the Vantage frame for performing DBS lead implants.

Methods: Retrospective review of all patients who underwent DBS using the Vantage frame with our surgeon between July 2021 and May 2022. Target and actual coordinates of implanted DBS leads were determined in BrainLab.

Results: Thirty-three electrode trajectories (17 left-sided, 16 right-sided) were included. On the right, actual electrode placement was, on average, 0.95 mm more medial, 1.06 mm more posterior, and 0.55 mm more superior compared with planned trajectories. The vector error was 1.93 ± 0.91 mm. On the left, actual electrode placement was 0.49 mm more lateral, 0.66 mm more posterior, and 0.67 mm more superior than planned trajectories. The vector error was 1.68 ± 0.66 mm. After excluding all electrodes that were repositioned after microelectrode recording and/or test stimulation, right-sided electrodes (n = 10) were 0.88 mm more medial, 0.94 mm more posterior, and 0.76 mm more superior than planned trajectories. The vector error was 1.74 ± 1.01 mm. Left-sided electrodes (n = 14) were 0.49 mm more lateral, 0.63 mm more posterior, and 0.49 mm more superior than planned trajectories. The vector error was 1.62 ± 0.68 mm.

Conclusion: This study demonstrated the accuracy of the Leksell Vantage frame in comparison with the traditional Leksell G frame.