Intra-catheter endoscopy for various shunting procedures—a retrospective analysis on surgical practicability, catheter placement, and failure rates

Antes, Sebastian; Linsler, Stefan; Salah, Mohamed; Senger, Sebastian; Oertel, Joachim

doi:10.1007/s00701-017-3264-3

Cited by 10 publications

(17 citation statements)

References 36 publications

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“…The complication rate due to VC placement was 13.2%. CSF or delayed shunt infections were determined in 7 patients and a wound-healing disorder in one patient [3]. In our study, we had better catheter placement rate using SG technique (90%) and comparable complication and revision rates.…”

Section: Discussionmentioning

confidence: 53%

“…Several studies reported good success rates, especially with di cult ventricular con gurations. [2,3,5,20,25]. However, these studies did not include a control group.…”

Section: Discussionmentioning

confidence: 99%

“…This allows the tip of the VC to be placed in the cerebrospinal uid (CSF) system under visual control while avoiding touching the ventricular wall or the plexus. In addition, many authors recommend the use of a narrow or wide endoscope tube in di cult ventricular anatomy, where other methods cannot achieve an optimal position [2,3,4,5,12,20,21,25].…”

Section: Introductionmentioning

confidence: 99%

“…The shuntoscope, in comparison to the conventional endoscopic guidance for catheter placement, is considered less invasive and less time consuming as the control is achieved through passing the shuntoscope directly through the catheter itself, and not parallel to it, which saves more time and have less incidence of complications associated with bigger burr hole and possible CSF leak or injury to the cortex through insertion of the endoscope itself, whether the optic lens alone or with the endoscopic sheath together [2,3,27]. To the best of our knowledge, this is the rst comparative study that investigates the e cacy of the shuntoscope-guided (SG) technique using the FH technique as a reference standard.…”

Section: Introductionmentioning

confidence: 99%

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Shuntoscope-Guided Versus Free Hand Technique for Ventricular Catheter Placement: A Prospective Comparative Study of Intra-Ventricular Catheter Tip Position and Complication Rate

Issa

Nofal

Miotk

et al. 2021

Preprint

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Background: The position of the ventricular catheter (VC) is essential for a proper function of cerebrospinal fluid diversion system. A shuntoscope-guided (SG) method might be helpful in reducing complications. Objective: The purpose of this study is to compare the accuracy of catheter placement and the complication and revision rates between SG and free hand (FH) techniques. Methods: A prospective study of patients who underwent VC placement between September 2018 and March 2021. Accuracy of catheter placement was graded on postoperative imaging using three-point Hayhurst grading system. Complication and revision rates were documented and compared between both groups with an average follow up period of 19.56 months. Results: Fifty-five patients were included. SG technique was used in 29 patients (mean age was 6.3 years, 1.4 –27.7 years, 48.1% females), and FH technique was used in 26 patients (mean age was 28.6 years, 1.0 – 79.5 years, 73.1% female). The success rate for the optimal placement of the VC with a grade I on the Hayhurst scale was significantly higher in the SG group (93.1%) than in the FH group (67%), P = 0.031. The revision rate was higher in the FH group with 31.8% vs. 20.7% of in the SG group, P = 0.396. Conclusion: VC placement using the SG technique is a safe and effective procedure, which enabled a significantly higher success rate and lower revision and complication rate. Accordingly, we recommend using the SG technique specially in patients with morbid anatomy.

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Section: Discussionmentioning

confidence: 53%

“…Several studies reported good success rates, especially with di cult ventricular con gurations. [2,3,5,20,25]. However, these studies did not include a control group.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Shuntoscope-Guided Versus Free Hand Technique for Ventricular Catheter Placement: A Prospective Comparative Study of Intra-Ventricular Catheter Tip Position and Complication Rate

Issa

Nofal

Miotk

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…This allows the tip of the VC to be placed in the cerebrospinal fluid (CSF) system under visual control while avoiding touching the ventricular wall or the plexus. In addition, many authors recommend the use of a narrow or wide endoscope tube in difficult ventricular anatomy, where other methods cannot achieve an optimal position [20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

ShuntScope-Guided Versus Free-Hand Technique for Ventricular Catheter Placement: A Retrospective Comparative Study of Intraventricular Catheter Tip Position and Complication Rate

Issa

Nofal

Miotik

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Background: The position of the ventricular catheter (VC) is essential for a proper function of cerebrospinal fluid diversion system. A ShuntScope®-guided (SG) method might be helpful in reducing complications. The purpose of this study is to compare the accuracy of catheter placement and the complication and revision rates between SG and free hand (FH) techniques. Methods: A retrospective study based on a prospectively acquired database of patients who underwent VC placement between September 2018 and July 2021. Accuracy of catheter placement was graded on postoperative imaging using three-point Hayhurst grading system. Complication and revision rates were documented and compared between both groups with an average follow up period of 20.84 months. Results: Fifty-seven patients were included. SG technique was used in 29 patients (mean age was 6.3 years, 1.4 –27.7 years, 48.1% females), and FH technique was used in 28 patients (mean age was 26.7 years, 0.83 – 79.5 years, 67.9% female). The success rate for the optimal placement of the VC with a grade I on the Hayhurst scale was significantly higher in the SG group (93.1%) than in the FH group (60.7%), P = 0.012. The revision rate was higher in the FH group with 35.7% vs. 20.7% of in the SG group, P = 0.211. Conclusion: VC placement using the SG technique is a safe and effective procedure, which enabled a significantly higher success rate and lower revision and complication rate. Accordingly, we recommend using the SG technique especially in patients with difficult anatomy.

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Image quality and related outcomes of the ShuntScope for catheter implantation in pediatric hydrocephalus—experience of 65 procedures

2022

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Purpose Ventricular catheter implantation in pediatric hydrocephalus can become a highly challenging task due to abnormal anatomical configuration or the need for trans-aqueductal stent placement. Transluminal endoscopy with the ShuntScope has been invented to increase the rate of successful catheter placements. This study aims to evaluate ShuntScope’s image qualities and related surgical outcomes in the pediatric population. Methods A retrospective analysis of all pediatric patients undergoing ventricular catheter placement using the ShuntScope from 01/2012 to 01/2022 in the author’s department was performed. Demographic, clinical, and radiological data were evaluated. The visualization quality of the intraoperative endoscopy was stratified into the categories of excellent, medium, and poor and compared to the postoperative catheter tip placement. Follow-up evaluation included the surgical revision rate due to proximal catheter occlusion. Results A total of 65 ShuntScope-assisted surgeries have been performed on 51 children. The mean age was 5.1 years. The most common underlying pathology was a tumor- or cyst-related hydrocephalus in 51%. Achieved image quality was excellent in 41.5%, medium in 43%, and poor in 15.5%. Ideal catheter placement was achieved in 77%. There were no intraoperative complications and no technique-related morbidity associated with the ShuntScope. The revision rate due to proximal occlusion was 4.61% during a mean follow-up period of 39.7 years. No statistical correlation between image grade and accuracy of catheter position was observed (p-value was 0.290). Conclusion The ShuntScope can be considered a valuable addition to standard surgical tools in treating pediatric hydrocephalus. Even suboptimal visualization contributes to high rates of correct catheter placement and, thereby, to a favorable clinical outcome.

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Intra-catheter endoscopy for various shunting procedures—a retrospective analysis on surgical practicability, catheter placement, and failure rates

Cited by 10 publications

References 36 publications

Shuntoscope-Guided Versus Free Hand Technique for Ventricular Catheter Placement: A Prospective Comparative Study of Intra-Ventricular Catheter Tip Position and Complication Rate

Shuntoscope-Guided Versus Free Hand Technique for Ventricular Catheter Placement: A Prospective Comparative Study of Intra-Ventricular Catheter Tip Position and Complication Rate

ShuntScope-Guided Versus Free-Hand Technique for Ventricular Catheter Placement: A Retrospective Comparative Study of Intraventricular Catheter Tip Position and Complication Rate

Image quality and related outcomes of the ShuntScope for catheter implantation in pediatric hydrocephalus—experience of 65 procedures

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