Acta Neurochirurgica

, Volume 159, Issue 10, pp 1991–1998 | Cite as

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

  • Sebastian Antes
  • Stefan Linsler
  • Mohamed Salah
  • Sebastian Senger
  • Joachim Oertel
Original Article - Neurosurgical Techniques

Abstract

Background

The long-term function of a cerebral shunt is directly influenced by the placement of the ventricle catheter. In this work, an intra-luminal endoscope for best possible catheter positioning was used. Practicability, 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 intraventricular stenting procedures (n = 20). Catheter positioning was graded on postoperative imaging using a four-point scale. All patients were regularly followed up (mean, 31.6 months) to recognize shunt 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% (44/68 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 also did not prove to be a risk factor for the observed complications.

Conclusions

Versatile application possibilities of the intra-catheter endoscope reflect the advantages of the technique. Independent of the performed procedure, unintended positionings or even complete catheter misplacements could be avoided. However, in more than one-third of all cases, suboptimal catheter placements became obvious. Interestingly, negative influences on later shunt failures were not seen.

Keywords

Shunt scope Neuroendoscopy Ventricle catheter placement Hydrocephalus Shunt failure 

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Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  • Sebastian Antes
    • 1
  • Stefan Linsler
    • 1
  • Mohamed Salah
    • 1
  • Sebastian Senger
    • 1
  • Joachim Oertel
    • 1
  1. 1.Department of NeurosurgerySaarland University Medical Center and Saarland University Faculty of MedicineHomburgGermany

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