Value of the Application of Neuroendoscope in the Treatment of Ventriculoperitoneal Shunt Blockage

Wei, Quantang; Xu, Yikai; Peng, Kangqiang; Qi, Songtao; Peng, Yu‐Ping; Ji, Huangyi; Li, Yu; Qiu, Mingxing; Ying, Yanyi; Qiu, Xiaoyu

doi:10.1016/j.wneu.2018.05.007

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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Removal of the Retained Ventricular Catheter Using the Endoscopic Monopolar Instrument

Pontes

Ferreira-Pinto

Simões

et al. 2021

Case Reports in Surgery

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Background. Ventriculoperitoneal shunt (VPS) remains the main treatment for hydrocephalus. However, VPS revision surgery is very common. Here, we present a case in which the retained ventricular catheter was removed using the endoscopic monopolar instrument. Methods. We report a case of a 28-year-old female who presented with VPS obstruction. She had two previous shunt revision surgeries due to shunt obstruction. Eleven years after the last one, she presented an abdominal pseudocyst that indicated a total system removal. During VPS revision surgery, a retained ventricular catheter was observed. The endoscopic monopolar instrument was introduced into the retained catheter under direct view. Coagulations in a back-and-forth movement were applied to release inner catheter adhesions. After these steps, the catheter was removed, and a new one was placed through the same route. Results. The catheter was removed without complications, confirmed by the postoperative cranial computed tomography. The patient remained asymptomatic. Conclusion. The described technique was effective and avoided ventricular bleeding. Further studies are necessary to validate this method.

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Section: Discussionmentioning

confidence: 99%

“…Removal of the ventricular catheter, when needed, may be risky. Plexus choroid adhesions increase the occurrence of intraventricular hemorrhage [4][5][6][7]. Here, we present a case in which the retained ventricular catheter was removed using the endoscopic monopolar instrument.…”

Section: Introductionmentioning

confidence: 95%

Removal of the Retained Ventricular Catheter Using the Endoscopic Monopolar Instrument

Pontes

Ferreira-Pinto

Simões

et al. 2021

Case Reports in Surgery

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show abstract

Section: Discussionmentioning

confidence: 99%

“…8 In fact, intraventricular shunt malfunction can also be caused by strong adhesions that can obliterate the catheter lumen, particularly in postinfectious multiloculate hydrocephalic patients. 9 Since surgical removal could be related to intraventricular hemorrhage risk in these cases, endoscopic extraction can represent a safe and effective alternative to open intraventricular surgery including septa opening, cystic areas fenestration, and catheter removal after performing bipolar coagulation adhesiolysis. 10,11 As also described by Babadagli et al, 12 the most suitable maneuver would be retrieval of the ventricular catheter from its tip and then perform a promptly traction via the peel-away sheath.…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscopic Navigated One-Step Removal of Crossed Ventricular Catheter Fragments: Technical Note

Calì

Scalia

Marrone³

et al. 2021

Journal of Pediatric Neurology

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Introduction Neuroendoscopy plays an important role in minimally invasive neurosurgery. The authors reported an interesting case of a pediatric patient with multiple ventriculoperitoneal shunt (VPS) revision surgeries, presenting with VPS infection and with two crossed intraventricular floating catheter fragments, successfully removed through a neuroendoscopic navigated one-step procedure. A literature review regarding this exceedingly rare condition has also been discussed. Case Description An 11-year-old female patient with a history of congenital hydrocephalus was admitted to the emergency department with symptoms of intracranial hypertension, psychomotor agitation, and tetraparesis. She had a history of previous multiple VPS revisions. She had an urgent brain computed tomography scan that documented hydrocephalus; the VPS's intraventricular catheter tip was sited at the level of the right frontal horn. Two small floating catheter fragments, not connected to the VPS, were identified: the first close to the right lateral ventricle at the level of the right occipital horn, the second one between the right occipital horn and the third ventricle. First, she underwent an exteriorization of the distal catheter for VPS. Cerebrospinal fluid examination documented hyperproteinorrachia and a positive culture for Staphylococcus aureus. Then a navigated right transfrontal endoscopic approach to the right lateral ventricle was performed extending to the previous burr hole and achieving a wide range of working angle with a rigid 0-degree lens endoscope. Intermittent irrigation generating convective flow was performed such as to mobilize the catheters tip gently upward, to remove them by grasping. Finally, a whole VPS replacement has been performed. Conclusion Persistence of intraventricular floating catheter fragments can lead to subacute or chronic infections. Neuroendoscopic retrieval represents a safe and effective alternative to a more extensive and invasive surgical approach. However, the exact catheter tip identification, grasping, and removal can be difficult to achieve, due to the technical instrumentation characteristics and altered intraventricular anatomy in chronic congenital hydrocephalus. In our experience, endoscopic convective flow induction through saline irrigation can determine floating intraventricular catheter fragments movement aiming to their identification and subsequent successful endoscopic retrieval.

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Endoscopic Septostomy for Treatment of Complex Hydrocephalus: A Single Center Retrospective Cohort

Perondi,

Basso,

Shuha

et al. 2024

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Objective The objective was to present the initial experience with endoscopic septostomy in a Brazilian public hospital. Methods A retrospective analysis was conducted on patients who underwent neuroendoscopic septostomy at the Department of Neurosurgery of Cristo Redentor Hospital in Porto Alegre from 2015 to 2021. Results In the period analyzed, 14 patients underwent endoscopic septostomy. The mean age of the patients was 41.86 years; 11 were male and 3 were female. The etiologies of hydrocephalus included ventricular inflammatory conditions, neoplasms, neurocysticercosis, and intraventricular cysts. Following septostomy, 64% of the patients exhibited clinical and radiological improvement. Complications occurred in 29% of the cases, including intraventricular hemorrhage and thalamic contusion. Four deaths were observed, all related to clinical complications or progression of the underlying disease. Conclusion Endoscopic septostomy is an effective and safe procedure for treating complex hydrocephalus of different etiologies. Surgical outcomes are related to the learning curve with neuroendoscopy, and the benefits for patients are evident, considering the possibility of safely and effectively performing simultaneous endoscopic procedures with septostomy.

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Value of the Application of Neuroendoscope in the Treatment of Ventriculoperitoneal Shunt Blockage

Cited by 5 publications

References 16 publications

Removal of the Retained Ventricular Catheter Using the Endoscopic Monopolar Instrument

Removal of the Retained Ventricular Catheter Using the Endoscopic Monopolar Instrument

Neuroendoscopic Navigated One-Step Removal of Crossed Ventricular Catheter Fragments: Technical Note

Endoscopic Septostomy for Treatment of Complex Hydrocephalus: A Single Center Retrospective Cohort

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