Ultrasound-guided placement of ventricular catheters in first-time pediatric VP shunt surgery

Kullmann, Marcel; Khachatryan, Marina; Schuhmann, Martin U.

doi:10.1007/s00381-017-3660-2

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…7 In some studies, occipital position of VPS has been inferior to frontal position regarding patency and functioning of the shunt. 8,9 An association between location of the shunt and correct positioning of the proximal catheter was not observed in the two cohorts. 10 Operation time was shorter in the US cohort.…”

Section: Study Results In Context With Current Literaturementioning

confidence: 82%

“…The rate of optimally placed catheters in the US cohort of our study is comparable to the results of other studies analyzing US-GVPS placement. 8 It has been shown in the literature that OC placement lowers the risk for shunt failure, and therefore the need for revision surgery. [14][15][16] This result could be confirmed in our study, since both patients in the US cohort requiring revision surgery showed NOC of their VPS.…”

Section: Study Results In Context With Current Literaturementioning

confidence: 99%

“…It was previously shown that US-G proximal catheter placement is significantly more accurate than freehand placement and that the use of intraoperative guidance techniques reduces proximal shunt failure. 7,8 The use of US has been associated with a statistically significant decrease in VPS revisions. 9 This accounts for studies done with adult patients; in children, these results could not be confirmed.…”

Section: Study Results In Context With Current Literaturementioning

confidence: 99%

“…6 To date, most of the clinical evidence regarding image-guided VPS placement derives from small retrospective cohort studies. [7][8][9] Since optimal shunt positioning is directly associated with shunt survival, measures should be taken to improve the accuracy of proximal catheter positioning. Accurate and feasible navigation methods need to become standard of care in VPS surgery without prolonging time of surgery or producing extra costs.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Insertion of the Ventricular Catheter in Ventriculoperitoneal Shunt Surgery: Evaluation of Accuracy and Feasibility in a Prospective Cohort

Leu

Kamenova

Mariani

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Objective Ventriculoperitoneal shunt (VPS) placement is one of the most frequent neurosurgical procedures. The position of the proximal catheter is important for shunt survival. Shunt placement is done either without image guidance (“freehand”) according to anatomical landmarks or by use of various image-guided techniques. Studies evaluating ultrasound-guided (US-G) VPS placement are sparse. We evaluate the accuracy and feasibility of US-G VPS placement, and compare it to freehand VPS placement. Methods We prospectively collected data of consecutive patients undergoing US-G VPS placement. Thereafter, the US cohort was compared with a cohort of patients in whom VPS was inserted using the freehand technique (freehand cohort). Primary outcome was accuracy of catheter positioning, and secondary outcomes were postoperative improvement in Evans' index (EI), rates of shunt dysfunction and revision surgery, perioperative complications, as well as operation, and anesthesia times. Results We included 15 patients undergoing US-G VPS insertion. Rates of optimally placed shunts were higher in the US cohort (67 vs. 49%, p = 0.28), whereas there were no malpositioned VPS (0%) in the US cohort, compared with 10 (5.8%) in the freehand cohort (p = 0.422). None of the factors in the univariate analysis showed significant association with nonoptimal (NOC) VPS placement in the US cohort. The mean EI improvement was significantly better in the US cohort than in the freehand cohort (0.043 vs. 0.014, p = 0.035). Conclusion Based on our preliminary results, US-G VPS placement seems to be feasible, safe, and increases the rate of optimally placed catheters.

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Section: Study Results In Context With Current Literaturementioning

confidence: 82%

Section: Study Results In Context With Current Literaturementioning

confidence: 99%

Section: Study Results In Context With Current Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-Guided Insertion of the Ventricular Catheter in Ventriculoperitoneal Shunt Surgery: Evaluation of Accuracy and Feasibility in a Prospective Cohort

Leu

Kamenova

Mariani

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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“…Initially, the entry point is measured according to standard anatomical landmarks, thereafter the catheter is placed into the ventricle under real-time US guidance along the depicted trajectory (10,11). To date, most of the clinical evidence regarding image-guided VPS placement derives from small retrospective cohort studies (11)(12)(13)(14). To date, studies comparing these two navigation methods in a prospective manner do not exist.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Ultrasound Guided compared to Stereotactic Navigated Ventriculoperitoneal Shunt Placement: Study Protocol for a Randomized Controlled Study

Leu

Halbeisen

Mariani

et al. 2021

Preprint

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Background Ventriculoperitoneal shunt (VPS) placement is one of the most frequent neurosurgical procedures. The position of the proximal ventricular catheter is important since it influences shunt functioning and survival. With freehand placement rates of malpositioned VPS are still high. Several navigation techniques for improvement of shunt placement have been development. Data comparing these techniques is sparse. The aim of this study is to prospectively compare ultrasound (US) guided to stereotactic navigated shunt placement with the focus on safety and feasibility. Methods In this prospective randomized, single-centre study we include all patients undergoing VPS placement in our clinic. The patients are randomized into two groups, one group undergoing US guided and the other group stereotactic navigated VPS placement. The study primarily seeks to compare the surgical intervention time between the two methods. Secondary objectives are different aspects of feasibility and safety of both methods. Discussion To date, there is no data available about the prospective comparison of these navigation techniques regarding feasibility and safety. A randomized controlled study is urgently needed in order to provide class I evidence for the best possible treatment of this large group of patients.

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Complication Avoidance in Neurosurgery with Use of Intraoperative Ultrasonography

Quigley

2023

Acta Neurochirurgica Supplement

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Ultrasound-guided placement of ventricular catheters in first-time pediatric VP shunt surgery

Cited by 16 publications

References 15 publications

Ultrasound-Guided Insertion of the Ventricular Catheter in Ventriculoperitoneal Shunt Surgery: Evaluation of Accuracy and Feasibility in a Prospective Cohort

Ultrasound-Guided Insertion of the Ventricular Catheter in Ventriculoperitoneal Shunt Surgery: Evaluation of Accuracy and Feasibility in a Prospective Cohort

Intraoperative Ultrasound Guided compared to Stereotactic Navigated Ventriculoperitoneal Shunt Placement: Study Protocol for a Randomized Controlled Study

Complication Avoidance in Neurosurgery with Use of Intraoperative Ultrasonography

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