Operative Complications with and without Image Guidance: A Systematic Review and Meta-Analysis of the Ommaya Reservoir Literature

Lau, Jonathan C.; Kosteniuk, Suzanne E.; Walker, Thomas; Iansavichene, Alla; Macdonald, David R.; Megyesi, Joseph F.

doi:10.1016/j.wneu.2018.11.036

Cited by 15 publications

(14 citation statements)

References 42 publications

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“…Despite being a relatively simple neurosurgical procedure, there are several key issues to consider in the placement of an Ommaya reservoir for patients with LMD. The catheter tip can be malpositioned and not reside in the intraventricular CSF, a complication that may occur in 3%–13% of patients (Lau et al, ). Strategies to improve this include the use of intraoperative CT scan or MRI, intraventricular pneumocephalograms (widely available), and stereotactic navigation (Lau et al, ).…”

Section: Neurosurgical and Other Clinical Issuesmentioning

confidence: 99%

“…The catheter tip can be malpositioned and not reside in the intraventricular CSF, a complication that may occur in 3%–13% of patients (Lau et al, ). Strategies to improve this include the use of intraoperative CT scan or MRI, intraventricular pneumocephalograms (widely available), and stereotactic navigation (Lau et al, ). There is a 1%–3.4% risk of intracerebral hemorrhage during catheter placement (Lau et al, ).…”

Section: Neurosurgical and Other Clinical Issuesmentioning

confidence: 99%

“…Strategies to improve this include the use of intraoperative CT scan or MRI, intraventricular pneumocephalograms (widely available), and stereotactic navigation (Lau et al, ). There is a 1%–3.4% risk of intracerebral hemorrhage during catheter placement (Lau et al, ). Intracranial hemorrhage can be delayed for up to 28 days following surgery (Sandberg, Bilsky, Souweidane, Bzdil, & Gutin, ).…”

Section: Neurosurgical and Other Clinical Issuesmentioning

confidence: 99%

See 2 more Smart Citations

Leptomeningeal disease in melanoma patients: An update to treatment, challenges, and future directions

Glitza

Smalley

Brastianos

et al. 2020

Pigment Cell Melanoma Res

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In February 2018, the Melanoma Research Foundation and the Moffitt Cancer Center hosted the Second Summit on Melanoma Central Nervous System Metastases in Tampa, Florida. The meeting included investigators from multiple academic centers and disciplines. A consensus summary of the progress and challenges in melanoma parenchymal brain metastases was published (Eroglu et al., Pigment Cell & Melanoma Research, 2019, 32, 458). Here, we will describe the current state of basic, translational, clinical research, and therapeutic management, for melanoma patients with leptomeningeal disease. We also outline key challenges and barriers to be overcome to make progress in this deadly disease.

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Section: Neurosurgical and Other Clinical Issuesmentioning

confidence: 99%

Section: Neurosurgical and Other Clinical Issuesmentioning

confidence: 99%

Section: Neurosurgical and Other Clinical Issuesmentioning

confidence: 99%

See 1 more Smart Citation

Leptomeningeal disease in melanoma patients: An update to treatment, challenges, and future directions

Glitza

Smalley

Brastianos

et al. 2020

Pigment Cell Melanoma Res

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“…Three days later, she began oral dasatinib and dexamethasone therapy per treatment protocol. The following day, a right frontal Ommaya reservoir was placed with the aid of electromagnetic intraoperative stealth guidance (6). The intraventricular catheter was inserted into the right frontal horn and clear CSF could be seen coming out.…”

Section: Case Reportmentioning

confidence: 99%

“…Ommaya reservoir use for chemotherapy administration has in some settings (e.g., leptomeningeal malignancy) shown higher overall survival compared to intrathecal chemotherapy via lumbar puncture (5). It has been used more extensively as image guidance techniques have advanced (6). Ommaya reservoir is indicated in treatment plans requiring repeated access to the intrathecal space.…”

Section: Introductionmentioning

confidence: 99%

Troubleshooting an unusual complication following intrathecal chemotherapy delivered via Ommaya catheter: A case report

et al. 2020

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The authors report the case of a 39-year-old woman with leukemic meningitis. A right frontal Ommaya reservoir was placed for intrathecal chemotherapy. During and immediately following the first injection of chemotherapy, the patient developed an episode of nausea, emesis, frontal headache and diarrhea. These same symptoms were later elicited during a second and third administration of chemotherapy. Post-placement head computed tomography showed the tip of the catheter projecting approximately 1.5 cm inferior to the floor of the left frontal ventricle. After a revision of the Ommaya catheter due to suboptimal positioning, subsequent intrathecal chemotherapy administration was tolerated without any of the adverse symptoms previously encountered. The case documents an unusual complication arising from catheter migration in the setting of intrathecal chemotherapy and also demonstrates the value in troubleshooting Ommaya reservoir complications rather than prematurely abandoning its use in favor of lumbar puncture.

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Complications of intracerebroventricular chemotherapy via subgaleal reservoir in primary central nervous system lymphoma: A single‐institution experience on 1247 installations in 94 consecutive patients

Anton

Margold

Kowalski

et al. 2021

Hematological Oncology

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The implantation of a subgaleal reservoir intracerebroventricular (ICV port) in order to apply ICV chemotherapy in patients with leptomeningeal cancer may be complicated by misplacement of the device, pericatheter leucencephalopathy, hemorrhage and iatrogenic ventriculitis/meningitis. Here we analyzed the occurrence of such complications in patients with primary central nervous system lymphoma (PCNSL) treated with systemic and ICV methotrexate‐ and cytarabine‐based chemotherapy. We retrospectively reviewed the medical records of 94 consecutive patients (1247 installations), who had received an ICV port for intraventricular chemotherapy for treatment of histologically confirmed PCNSL at our institution between September 2005 and October 2018. Infectious and noninfectious complications were systematically recorded including clinical, laboratory, and imaging data. In 9/94 patients (9.6%), a misplacement of the ICV port seen on the postoperative computed tomography scan was corrected immediately and chemotherapy was then continued as planned. In 5/94 patients (5.3%), symptomatic noninfectious complications were observed (four patients with symptomatic pericatheter leucencephalopathy and one patient with surgical scar dehiscence with CSF leak). In 8/94 patients (8.5%), asymptomatic white matter lesions around the catheter were visible on cerebral magnetic resonance imaging after completion of therapy. The rate of infectious complications was 6/94 patients (6.4%). No complication was lethal or required intensive care monitoring. This retrospective study shows that complications of ICV treatment have to be expected in a fraction of patients, however, in this series these complications were manageable and did not result in long‐term deficits.

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Operative Complications with and without Image Guidance: A Systematic Review and Meta-Analysis of the Ommaya Reservoir Literature

Cited by 15 publications

References 42 publications

Leptomeningeal disease in melanoma patients: An update to treatment, challenges, and future directions

Leptomeningeal disease in melanoma patients: An update to treatment, challenges, and future directions

Troubleshooting an unusual complication following intrathecal chemotherapy delivered via Ommaya catheter: A case report

Complications of intracerebroventricular chemotherapy via subgaleal reservoir in primary central nervous system lymphoma: A single‐institution experience on 1247 installations in 94 consecutive patients

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