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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Accuracy of intra-catheter endoscopy in shunting procedures

Meeting Abstract

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  • Sebastian Antes - Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
  • Stefan Linsler - Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
  • Mohamed Salah - Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
  • Sebastian Senger - Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
  • Joachim Oertel - Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.14.07

doi: 10.3205/17dgnc259, urn:nbn:de:0183-17dgnc2592

Published: June 9, 2017

© 2017 Antes et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The long-term function of a cerebral shunt is directly influenced by the placement of the ventricle catheter. In this study, an intra-luminal endoscope for best possible catheter positioning was used. Postoperative imaging and shunt failure rates were retrospectively evaluated.

Methods: Between January 2012 and June 2016, an intra-catheter endoscope was applied in 71 procedures. Endoscopic technique was used for catheter placement in first-time shunting or cerebrospinal fluid reservoir insertion (n=38), revision surgery in proximal shunt failure (n=13) and various intraventricluar stenting procedures (n=20). Catheter positioning was graded on postoperative imaging using a 4-point scale. All patients were regularly followed up (mean, 31.6 months) to recognize ventricle catheter failures.

Results: Endoscopic application could be completed as intended in 68 of 71 procedures. Postoperative imaging could exclude complete misplacement of all catheters, but optimal positioning was only achieved in 64.7 % (44 of 68 cases). Four catheters had to be revised due to malfunction (failure rate, 5.8 %). Another five catheters had to be removed due to infectious complications or wound healing disorders. Direct correlations between catheter complications and suboptimal catheter positioning were not seen. Slit or distorted ventricles did also not prove to be a risk factor for the observed complications.

Conclusion: Complete misplacements can be avoided by using an intra-catheter endoscope. Confirmation of intraventricular location by direct view attributes to the low malfunction rate, especially in slit or distorted ventricles.