OU Researchers, Oklahoma Start-up Aim to Transform Cranial Care

Two researchers from the University of Oklahoma are partnering with Oklahoma start-up Xironetic to develop innovative methods for neurosurgical guidance, visualization and training.

David R. Miller, Ph.D., an assistant professor at the Stephenson School of Biomedical Engineering, has developed a method for visualizing blood flow and tissue perfusion during brain surgery for which Christopher Graffeo, M.D., M.S., a neurosurgeon at the University of Oklahoma College of Medicine, is leading the testing. Graffeo is optimistic that the technology may help identify and prevent complications such as stroke before they arise.

In 2022, Xironetic, founded by OU College of Medicine surgeon Christian El-Amm, M.D., gained FDA clearance for its first device, IntraOpVSP. This device uses three-dimensional holographic overlays viewed through an augmented reality headset to enhance intraoperative visualization. Graffeo is assessing IntraOpVSP across a wide range of clinical applications aimed at improving procedural safety and enhancing trainee learning opportunities.

Jeff Potts, Ph.D., Chief Technology Officer at Xironetic explains that one such application is the insertion of an external ventricular drain (EVD) catheter. This standard and lifesaving procedure is usually performed “blind” at the bedside, without imaging guidance.

 “Even though EVD placement is a very common and safe procedure, errors are not rare, and repeat attempts are often needed, especially in patients with abnormal anatomy due to their disease,” Graffeo said. “We do these procedures blind, and so the potential for anything from a minor misplacement that compromises function to a major issue such as bleeding or injury to the brain is feasible. The overall complication rate is realistically about 1%, but it’s also the single most common procedure we do in neurosurgery, so on a long enough timeline, those unfortunate cases accrue.

“Real-time navigation guided by augmented reality would be a total game changer, and our hope is that we can significantly reduce the risk of EVD placement by integrating IntraOpVSP,” he added.

Miller and Potts are also working on integrating their technology to enable blood flow visualizations through an augmented reality device. Together with Graffeo, they are applying for a National Institute of Health grant that promotes partnerships between academia and industry to address important clinical problems.

Miller says the team is “optimistic about the potential for these technologies to significantly impact neurosurgical operations, with benefits including reduced complications, improved efficiency and, most importantly, enhanced patient safety.”