Article
Endoscopic stenting utilizing the ventricular catheter in complex hydrocephalus
Search Medline for
Authors
Published: | April 28, 2011 |
---|
Outline
Text
Objective: Complex multicompartment hydrocephalus requires endoscopic fenestrations, multiple ventricular catheters or both. The aim of our study was to evaluate the concept of using one single catheter as a stent between formerly isolated ventricular compartments and as a proximal ventricular catheter of a VP-Shunt.
Methods: We prospectively followed 16 patients, who underwent treatment of complex multicompartment hydrocephalus within a 3 year period between March 2006 and February 2009. All patients underwent a combined treatment consisting of endoscopic fenestration, stent placement and placement of a gravitational shunt (Paedi-GAV, Pro-GAV), utilizing the stent (conventional ventricular catheter / EVD with additional side holes) as the proximal catheter. Patients were followed clinically and with MRI studies.
Results: Endoscopic communication of formerly isolated ventricular compartments was established in all patients. Collapse of the ventricular system was avoided by the gravitational unit and / or the adjustability of the valves. The single proximal catheter / stent served reliably in 13 of the 16 patients as part of the shunt system. Within the follow-up period of 28 months (12–46 months) one shunt revision was required.
Conclusions: The combination of endoscopy with simplification of a pre-existing complex hydrocephalus, the placement of a stent to avoid reclosure of the fenestration sites and placement of gravitational shunt provides long-lasting adequatet treatment. The stent can be utilized safely and reliably as a single proximal ventricular catheter of a VP-Shunt.