Migration of a Ventriculoperitoneal Shunt into the Pulmonary Artery

Morell, Robert C.; Bell, William O.; Hertz, Gabor; D'Souza, Vincent J.

doi:10.1097/00008506-199404000-00010

Cited by 49 publications

(35 citation statements)

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“…The location of the catheter entry into the circulation was not identified. 6) In the most recent case, the catheter was coiled in the heart and was found by three-dimensional CT to have entered the heart via the internal jugular vein. The catheter was relocated by pulling it through a neck incision to place the tip in the atrium as in a ventriculoatrial shunt.…”

Section: Discussionmentioning

confidence: 99%

“…Perforation of the external jugular vein by the shunt guide is difficult to detect during surgery. This type of migration may be lethal, possibly causing pulmonary emboli, arrhythmia, sepsis, or cardiac insufficiency, 2,6) so periodic follow-up radiography should be scheduled after VP shunt placement.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,[7][8][9] Migration to the heart or the pulmonary artery is quite unusual, with only three such cases reported. [4][5][6] We have experienced a fourth such case and identified the entry point of the catheter into the external jugular vein at surgery.…”

Section: Introductionmentioning

confidence: 99%

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Peritoneal Shunt Migration into the Pulmonary Artery. Case Report.

Kubo

Takimoto

Takakura

et al. 2002

Neurol. Med. Chir.(Tokyo)

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A 48-year-old man underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to left vertebral artery dissection, which had been successfully treated by trapping. The peritoneal catheter was correctly positioned via a right upper abdominal incision, and symptoms related to the hydrocephalus disappeared. One month later, the patient began to complain of pain on the right side of the neck. Chest radiography revealed that the peritoneal end of the catheter had migrated into the right pulmonary artery. The catheter route was explored through a small neck incision, and was found to enter the external jugular vein. The catheter was extracted and repositioned into the peritoneum. This type of shunt migration is quite unusual, but could be lethal by causing pulmonary infarction or arrhythmia. The catheter had probably entered the external jugular vein through a perforation caused by the shunt guide during the ventriculoperitoneal shunt operation. Follow-up radiography should be scheduled to detect such a complication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Peritoneal Shunt Migration into the Pulmonary Artery. Case Report.

Kubo

Takimoto

Takakura

et al. 2002

Neurol. Med. Chir.(Tokyo)

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show abstract

“…The review by Fewel et al 9) indicates that percutaneous removal of the distal catheter can be achieved as safely as withdrawal of a standard ventriculoatrial shunt or central venous line. In contrast, Morell et al 6) emphasized that percutaneous removal can be problematic if the interval between initial shunt insertion and diagnosis of the migration is long because of adhesion of the shunt catheter to the pulmonary artery or intracardiac structures. Moreover, the possibility of embolic formation along with the catheter might be higher in such patients.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10] The intervals between the VP shunt operation and a diagnosis of migration ranged from 18 days to 4 years. The shunt catheter had penetrated the right internal jugular vein in two patients, the right external jugular vein in two, and the remaining two were not described.…”

Section: Discussionmentioning

confidence: 99%

Migration of Distal Ventriculoperitoneal Shunt Catheter into the Pulmonary Artery

Ryugo

Imagawa

Nagashima

et al. 2009

Annals of Vascular Diseases

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hospital during March 2006. The shunt catheter was easily placed subcutaneously by tunneling with an ordinary shunt passer. The abdominal catheter was introduced into the peritoneum via an incision over the right rectus muscle. Postoperative abdominal radiography confirmed that the catheter was correctly positioned (Fig. 1A).Two years after VP shunting, the patient presented with a bulge at the site of the abdominal incision, and a hernia was diagnosed. The patient provided written, informed consent to undergo repair of the incisional hernia and he was thus examined in more detail preoperatively. Chest radiography revealed that the peritoneal end of the catheter had migrated into the right pulmonary artery (Fig. 1B). A CT examination from the neck to the thorax showed the tube passing through the superior vena cava, right atrium and right ventricle, into the main pulmonary artery, and then into the right pulmonary artery ( Fig. 2A and B). After consultation with his original physician regarding removal of the catheter, the patient was transferred to our hospital on November 4, 2008, where he provided written informed consent to the procedure, which was performed on November 7, 2008.Operation: The patient was placed in the supine position and a temporary filter catheter (Toray Medical, Tokyo, Japan) was positioned under general anesthesia from the right femoral vein to the main pulmonary artery using the previous transluminal guide to prevent distal em- A 50-year-old man presented with an abdominal bulge 2 years after receiving a ventriculoperitoneal (VP) shunt for hydrocephalus. Chest radiography revealed that the peritoneal end of the catheter had migrated into the right pulmonary artery. Exploration through a small neck incision revealed that the shunt catheter had entered the internal jugular vein. The catheter was extracted and positioned in the subcutaneous space in preparation for reimplantation. This type of shunt migration is quite unusual, but it could cause lethal pulmonary infarction or arrhythmia. Follow-up radiography should be scheduled to detect such complications. Migration of Distal Ventriculoperitoneal Shunt Catheter into the Pulmonary Artery

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Retrieval of “old” foreign bodies from the cardiovascular system in children

Farrell

Parikh

Darragh

et al. 1998

Cathet. Cardiovasc. Diagn.

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Several techniques have been developed to retrieve catheter and guide wire fragments that have embolized to the heart and pulmonary vasculature. In most instances, retrieval of the embolized fragments is performed soon after the event has occurred. In this report, we summarize our experience with the removal of these fragments in 3 children after a significant amount of time had elapsed since the time of embolization. The embolized catheter and guide wire fragments were removed without any complications. We also describe the techniques used for their removal, and the problems encountered during the removal of these “old” foreign bodies. Cathet. Cardiovasc. Diagn. 44:212–216, 1998. © 1998 Wiley‐Liss, Inc.

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Migration of a Ventriculoperitoneal Shunt into the Pulmonary Artery

Cited by 49 publications

References 0 publications

Peritoneal Shunt Migration into the Pulmonary Artery. Case Report.

Peritoneal Shunt Migration into the Pulmonary Artery. Case Report.

Migration of Distal Ventriculoperitoneal Shunt Catheter into the Pulmonary Artery

Retrieval of “old” foreign bodies from the cardiovascular system in children

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