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Aqueductal stenting with an intra-catheter endoscope—a technical note

  • Technical Note
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Abstract

Introduction

Aqueductoplasty as well as aqueductal stenting is an accepted therapy option in short-segment aqueductal stenosis and isolated fourth ventricle. Over the years, different techniques with only slight modifications by using a conventional neuroendoscope with a working sheath to introduce different instruments have been presented. In summary, the use of Fogarty balloon catheters or flexible endoscopes to pass the narrowed aqueduct is recommended.

Methods

This technical report describes a substantially new technique for this purpose. Six patients underwent aqueductal stenting with a new intracatheter endoscope.

Results

Aqueductal stenting was possible in 4 out of 6 cases. No complications occurred. Handling of this new technique was good and easy without a prolonged learning curve. All four stents did work appropriately, and the procedure was considered to be successful. Of the two failures, the technique was abandoned and endoscopic third ventriculostomy (ETV) was performed in one. In the other case, suboccipital shunting was done.

Conclusion

This technical report describes a substantially new technique for aqueductal stenting. The combination of an intracatheter miniature endoscope and a prepared ventricular catheter enables careful and elegant aqueductal stenting. Large or flexible endoscopes, balloons, or special instruments to place a stent have become completely obsolete in selected cases.

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Fig. 1
Fig. 2

Abbreviations

CSF:

Cerebrospinal fluid

ETV:

Endoscopic third ventriculostomy

MRI:

Magnetic resonance imaging

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Acknowledgments

We would like to thank Mr. Rüdiger Koop (Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany) for producing and processing the figures.

Disclosure

Joachim Oertel is consultant to the Karl Storz company (Karl Storz GmbH & Co. KG, Tuttlingen, Germany).

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany

    Sebastian Antes, Mohamed Salah, Stefan Linsler, Christoph A. Tschan, David Breuskin & Joachim Oertel

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  1. Sebastian Antes
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  2. Mohamed Salah
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  3. Stefan Linsler
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  4. Christoph A. Tschan
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  5. David Breuskin
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  6. Joachim Oertel
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Correspondence to Joachim Oertel.

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Antes, S., Salah, M., Linsler, S. et al. Aqueductal stenting with an intra-catheter endoscope—a technical note. Childs Nerv Syst 32, 359–363 (2016). https://doi.org/10.1007/s00381-015-2902-4

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  • DOI: https://doi.org/10.1007/s00381-015-2902-4

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