Neuroendoscopic Assessment of Choroid Plexus Coagulation to Release Ventricular Catheter: Note on the Seldinger Technique

Abstract

Shunting is fundamental in neurosurgical practice and a large number of patients experience shunt dysfunction throughout life. The Seldinger technique seems to be a valuable tool in the management of dysfunctions and consists of coagulating the choroid plexus before shunt removal. We report the unique case of a neuroendoscopic view of choroid plexus coagulation by the Seldinger technique in a 7-year-old child with shunt dysfunction submitted to endoscopic third ventriculostomy and previous shunt removal. We reinforce the security and efficacy of the Seldinger technique with a direct neuroendoscopic view of the coagulation process.

Removal of the Retained Ventricular Catheter Using the Endoscopic Monopolar Instrument

“…Currently, VPS remains the most performed procedure for hydrocephalus treatment [3,10]. However, shunt failures and revision surgeries are common [11].…”

“…Percutaneous coagulation of the choroid plexus using the Seldinger technique was utilized by Gnanalingham et al [19]. Successful removal using an endoscopic view inside [6] or outside the catheter [3,7] has also been described. Finally, Haldar et al [5] have successfully included the use of the Valsalva maneuver to release the ventricular catheter.…”

“…Ventriculoperitoneal shunt (VPS) remains the main treatment for hydrocephalus [1,2]. Approximately 50% of shunts fail, requiring replacement [3]. Removal of the ventricular catheter, when needed, may be risky.…”