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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Long-term reliability of neuroendoscopic aqueductoplasty in hydrocephalus due to idiopathic stenosis of the aqueduct

Meeting Abstract

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  • Sascha Marx - Universitätsmedizin Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • Jörg Baldauf - Universitätsmedizin Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • Marc Matthes - Universitätsmedizin Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • Michael R. Gaab - Universitätsmedizin Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • Henry W. S. Schroeder - Universitätsmedizin Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV151

doi: 10.3205/18dgnc154, urn:nbn:de:0183-18dgnc1546

Veröffentlicht: 18. Juni 2018

© 2018 Marx et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Endoscopic aqueductoplasty (AP) was considered to be an alternative approach to endoscopic third ventriculostomy (ETV) in hydrocephalus related to idiopathic aqueductal stenosis in the 1990ies. After promising preliminary reports, little is known about the long-term efficacy of AP.

Methods: The authors report their long-term results of AP for the treatment of idiopathic stenosis of the aqueduct.

Results: 20 patients (14f, 6m, mean age 41.7 years, range from 0.5 to 67 years) were treated at our institution between 1996 and 2002. 2/ 20 patients were lost to follow-up. 1/ 20 patients died 6 months after aqueductoplasty, but not related to the procedure itself. Mean follow-up for 17 patients was 120 months. Clinically relevant aqueductal reclosure was observed in 11/ 17 patients after a mean follow-up of 53 months. All of them underwent an ETV, 5/ 11 combined with a re-AP. All ETV remained successful in the further follow up. In 4/ 17 other patients, MRI revealed clinically silent aqueductal restenosis after a mean follow up of 92 months. AP-success was observed in 2/ 17 patients. Kaplan-Meier-Analysis revealed a homogenous distribution of AP failures over the whole follow-up period.

Conclusion: Our study indicates a high risk of AP failure in the treatment of idiopathic aqueductal stenosis during long-term follow-up. ETV should be the procedure of first choice to treat idiopathic aqueductal stenosis. AP remains reserved for a limited number of patients, when ETV is not feasible, but should then be combined with stenting to avoid reclosure of the aqueduct.