Combined Frameless Stereotaxy and Neuroendoscopy in Placement of Intracranial Shunt Catheters

McCallum, Jack E.

doi:10.1159/000121177

Cited by 21 publications

(12 citation statements)

References 7 publications

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“…Frameless stereotaxy has emerged as an alternative to traditional frame-based stereotaxy for many applications such as planning and guidance for neuroendoscopy [15][16][17] , brain biopsy [18] , drainage of arachnoid cysts [19] and cystic tumors [20] , and placement of shunt catheters [9,21,22] . In the current case series, utilizing frameless surgical navigation, we have placed catheters connected to Ommaya reservoirs, to the desired target and provided conduits that could be safely utilized 100% of the time to instill chemotherapeutics while maintaining a serious complication rate below published averages for other techniques [3,4,6,7] .…”

Section: Discussionmentioning

confidence: 99%

Catheter Placement for Ommaya Reservoirs with Frameless Surgical Navigation: Technical Note

Greenfield

Schwartz²

2007

Stereotact Funct Neurosurg

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Objective: Infusion of intraventricular chemotherapy requires precise ventricular catheter placement in oncology patients to avoid intraparenchymal infusion. We assessed the safety and precision of using frameless surgical navigation for the placement of Ommaya reservoir catheters. Methods: In 20 consecutive patients who required Ommaya reservoirs for the administration of intrathecal chemotherapy, the catheters were positioned with the guidance of frameless stereotaxy. Precision of catheter placement, operative time, operative complications, and postoperative complications were assessed. Results: All catheters were completely within cerebrospinal fluid and 90% were within 5 mm of the intended target, the ipsilateral foramen of Monro. The average operative time was 47 min, and there were no intraoperative complications. There were no reports of leukoencephalopathy, and 3 patients had minor delayed complications. Conclusion: Frameless surgical navigation is a useful and efficient method for ensuring accurate catheter placement during Ommaya reservoir implantation, and it reduces the risk of potential parenchymal toxicity.

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Section: Discussionmentioning

confidence: 99%

Catheter Placement for Ommaya Reservoirs with Frameless Surgical Navigation: Technical Note

Greenfield

Schwartz²

2007

Stereotact Funct Neurosurg

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“…Incorporating endoscopic instruments into the stereotactic process has also been done. McCallum [7] reported combining endoscopy with stereotaxy. After a 1-mm endoscope was passed into the ventricle under stereotactic control, a side port was used to pass the shunt catheter under direct endoscopic vision.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Placement of Ventricular Catheters: Does It Affect Proximal Malfunction Rates?

Sampath

Wadhwa²,

Tawfik³

et al. 2012

Stereotact Funct Neurosurg

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Background: The majority of ventriculoperitoneal (VP) shunt malfunctions are due to proximal catheter failure. Ideal placement of Ommaya reservoirs is desired to avoid toxicity from intraparenchymal chemotherapy infusion. Objective: To determine whether stereotactic placement of ventricular catheters decreases the rate of Ommaya reservoir complications and the rate of proximal VP shunt failure. Methods: Under institutional review board approval, areview of a prospectively collected database was doneidentifying all patients who underwent stereotactic-guided placement of VP shunts and Ommaya reservoirs performed by a single surgeon between November 2007 and November 2009. Neuronavigation was used to preset a surgical plan consisting of an ideal entry point (usually frontal) and target point (ipsilateral foramen of Monro). The navigation probe was passed along this trajectory. After removal of the navigation probe, pre-sized ventricular catheters were passed without a stylet along the created path. Post-operative CT scans and clinical follow-up were assessed. Results: 70 patients (mean age 44.6 years) underwent 52 VP shunt and 18 Ommaya reservoir placement procedures. Rigid cranial fixation was used in all cases. All catheters were placed in a single pass. Mean operative time was 62 min. Mean follow-up was 16.3 months. No proximal malfunctions or Ommaya complications have been seen thus far. One patient required repositioning of an Ommaya reservoir as post-operative CT showed poor placement (1.4%). One patient with hydrocephalus due to cryptococcal meningitis developed an abdominal abscess and required removal of his entire shunt with subsequent replacement. One patient was noted to have a small amount of intraventricular hemorrhage; this did not result in any clinical change and did not require any further intervention. No other surgical complications were noted. Conclusion: In terms of results corroborating decreased proximal malfunction rates, we present the largest series of stereotactic-guided ventricular catheter placements to date. Though time in the operating room is increased due to navigation registration, actual operative time is comparable to procedures without navigation. A longer-term follow-up is needed to assess the longevity of our positive short-term results.

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“…Despite several reports describing the efficacy of frameless stereotactic guidance in ventricular catheter placement, there is very little in the literature regarding the use of electromagnetic neuronavigation (EMN) for this purpose [10,[22][23][24]. In this report, we describe our experience with frameless, pinless electromagnetic image guidance during the placement of Ommaya reservoirs for chemotherapy in 12 patients, and compare the results to retrospectively collected data from a cohort of 16 patients who underwent the identical procedure utilizing LED-based optical navigation.…”

Section: Introductionmentioning

confidence: 99%

Ommaya reservoir with ventricular catheter placement for chemotherapy with frameless and pinless electromagnetic surgical neuronavigation

Weiner

Chivukula

Chen

et al. 2015

Clinical Neurology and Neurosurgery

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Combined Frameless Stereotaxy and Neuroendoscopy in Placement of Intracranial Shunt Catheters

Cited by 21 publications

References 7 publications

Catheter Placement for Ommaya Reservoirs with Frameless Surgical Navigation: Technical Note

Catheter Placement for Ommaya Reservoirs with Frameless Surgical Navigation: Technical Note

Stereotactic Placement of Ventricular Catheters: Does It Affect Proximal Malfunction Rates?

Ommaya reservoir with ventricular catheter placement for chemotherapy with frameless and pinless electromagnetic surgical neuronavigation

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