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J Neurol Surg A Cent Eur Neurosurg 2023; 84(06): 521-527
DOI: 10.1055/a-1768-3892
Original Article

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

Mohammed Issa 
1   Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
,
Mohammed Nofal
1   Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
,
Nikolai Miotk
2   Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
,
Angelika Seitz
2   Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
,
Andreas Unterberg
1   Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
,
Ahmed El Damaty 
1   Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
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Funding None.
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Abstract

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 This is 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 the 3-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. The SG technique was used in 29 patients (mean age was 6.3 years, 1.4–27.7 years, 48.1% females), and the 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 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% versus 20.7% 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.

Keywords

CSF - free-hand - hydrocephalus - shunt system - ventricular catheter

Previous Presentation

The results of this study were presented at the meeting of German Society of Neurosurgery 2021 online (DGNC “Deutsche Gesellschaft der Neurochirurgie”; Abstract and Presentation).


Author Contribution

The corresponding author is responsible for the conception or design of the work, or the acquisition, analysis or interpretation of data, drafting the work, and revising it critically for important intellectual content, final approval of the version submitted.


The senior author is responsible for critically revising the version submitted, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


We, the authors, declare that there is no financial/personal interest or belief that could affect our objectivity in this work.




Publikationsverlauf

Eingereicht: 17. November 2021

Angenommen: 07. Februar 2022

Accepted Manuscript online:
10. Februar 2022

Artikel online veröffentlicht:
29. September 2023

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