Difficulties of Distal Catheter Insertion of Ventriculoatrial Shunting in Infants and Little Children
Erdogan, Hakan and Altun, Adnan and Kuruoglu, Enis and Kaya, Ahmet Hilmi
and Dagcinar, Adnan
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Abstract
AIM: Ventriculoatrial (VA) shunting is a well-described cerebrospinal
fluid diversion method for the treatment of hydrocephalus. However, it
may be very challenging in infants and little children because of atrial
catheter placement difficulties. This study aimed to create an algorithm
to solve problems faced during open surgical procedures based on the
present authors' experience.
MATERIAL and METHODS: We conducted a retrospective analysis on 18
infants and children who underwent VA shunt inserrtion at the Department
of Neurosurgery, Ondokuz Mayis University School of Medicine Hospital
between 2005 and 2012. Complications, clinical outcomes, revisions, and
solutions for overcoming distal catheter placement difficulties were
evaluated.
RESULTS: Twenty-six VA shunt operations were performed in 18 patients.
Six patients required eight VA shunt revisions. VA shunting was
primarily performed from the internal jugular, facial, cephalic, and
subclavian veins to the right atrium. In revision procedures, the
internal jugular, cephalic, and subclavian veins were used.
CONCLUSION: VA shunting in infants and little children requires careful
surgical techniques. Neurosurgeons should necessarily have an
appropriate strategy for VA shunting considering the complications and
revisions. Our results suggest open surgical solutions to overcome
distal catheter placement difficulties in this age group.... Show more Show less