Surface ultrastructure of tissues occluding ventricular catheters

Abstract

Specimens of material occluding ventricular catheters removed at shunt revision operations were studied by scanning electron microscopy. Immediate fixation allowed examination of human choroid plexus and ependyma which resembled living tissue.

Ventricular catheter placement accuracy in non-stereotactic shunt surgery for hydrocephalus

“…[2][3][4] Theories on how the approaches differ based on seizure risk, 5-7 choroid plexus obstruction, [8][9][10][11][12] size of target ventricular chamber 13 and incidence of infection 3,14 rightly remain controversial.…”

Biomaterials for the central nervous system

“…The proximal catheter is multi-perforated in order to enable the CSF to pass through; these drain holes allow for tissue ingrowth into the lumen of catheters. Shunt obstruction caused by tissue ingrowth through the drain holes has been widely reported, and choroid plexus and glial tissue account for the majority of offending tissues (Collins et al 1978;Del Bigio & Fedoroff 1992;Del Bigio 1998;Ginsberg et al 2000). In addition, scanning electron microscopy studies have shown biofilm formation on both inner and outer surface of the shunts (Guevara et al 1987;Koga et al 1992;Fux et al 2006).…”

A survey of surgical techniques for catheterising the cerebral lateral ventricles

“…Several influential clinical and pathological papers confirmed choroid plexus ingrowth as a significant cause of catheter blockage. [5][6][7][8] The use of endoscopy to direct the catheter away from the choroid plexus was investigated in a high-quality randomised trial and showed that this method failed to achieve distance of the tip from the choroid plexus or improve clinical outcome. 9 Other stereotactic aids designed to reduce variability of measurements and trajectories based on generic landmarks have been developed and shown to be of some value, although the uptake of these techniques by other surgeons is unknown.…”