The accuracy of ventricular catheter placement: does it influence shunt revision rates?

Price, Stephen J.; Santarius, Thomas; Richards, Hugh K.; Whiting, Gemma; Georges, Husam; Laing, Rodney

doi:10.1186/1743-8454-3-s1-s8

Cited by 6 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The only independent predictor for shunt revision was catheter tip location, and our observations concur with preceding studies. 1-4,6,19 We also noted that a contributing factor for achieving optimal placement was adopting Keen's point (88%, 15/17). This is in agreement with the results of Lind et al 9 in which this parietal entry point offered a significantly greater range of possible angles for successful cannulation than the occipital approaches.…”

Section: Discussionmentioning

confidence: 93%

“…It is well-established that optimal ventricular catheter placement is important in preventing CSF shunt malfunction. [1][2][3][4]6 Improving catheter accuracy is, therefore, a subject of intense clinical research. Such efforts can be categorized as either imageguided (intraoperative ultrasound, fluoroscopy, or stereotactic neuronavigation) or endoscopic-assisted.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated tip location to be associated with catheter occlusion, the commonest cause for shunt failure in 30% to 50% of patients. [1][2][3][4][5][6][7] Conventional approaches dictated by surface anatomic landmarks, craniometric points, have largely been adopted for historical reasons, and there is considerable variation in practice regarding entry site selection. [8][9][10] They include the frontal (Kocher's point), parietal (Keen's point), and occipital (Frazier's or Dandy's point) approaches.…”

mentioning

confidence: 99%

See 2 more Smart Citations

A Morphometric Analysis of Commonly Used Craniometric Approaches for Freehand Ventriculoperitoneal Shunting

Woo

Wong

Yuan

et al. 2021

Operative Neurosurgery

View full text Add to dashboard Cite

BACKGROUND: Ventricular catheter tip position is a predictor for ventriculoperitoneal shunt survival. Cannulation is often performed freehand, but there is limited consensus on the best craniometric approach. OBJECTIVE: To determine the accuracy of localizing craniometric entry sites and to identify which is associated with optimal catheter placement. METHODS: This is a retrospective analysis of adult patients who underwent ventriculoperitoneal shunting. The approaches were categorized as Kocher's, Keen's, Frazier's and Dandy's points as well as the parieto-occipital point. An accurately sited burr hole was within 10 mm from standard descriptions. Optimal catheter tip position was defined as within the ipsilateral frontal horn. RESULTS: A total of 110 patients were reviewed, and 58% (65/110) of burr holes were accurately sited. Keen's point was the most correctly identified (65%, 11/17), followed by Kocher's point (65%, 37/57) and Frazier's point (60%, 3/5). Predictors for accurate localization were Keen's point (odds ratio 0.3; 95% CI: 01-0.9) and right-sided access (odds ratio 0.4; 95% CI: 0.1-0.9). Sixty-three percent (69/110) of catheters were optimally placed with Keen's point (adjusted odds ratio 0.04; 95% CI: 0.01-0.67), being the only independent factor. Thirteen patients (12%) required shunt revision at a mean duration of 10 ± 25 mo. Suboptimal catheter tip position was the only independent determinant for revision (adjusted odds ratio 0.11; 95% CI: 0.01-0.98). CONCLUSION: This is the first study to compare the accuracy of freehand ventricular cannulation of standard craniometric entry sites for adult patients. Keen's point was the most accurately sited and was a predictor for optimal catheter position. Catheter tip location, not the entry site, predicted shunt survival.

show abstract

Section: Discussionmentioning

confidence: 93%