Distal catheter lengthening in pediatric patients with hydrocephalus using a guidewire-assisted technique
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ORIGINAL ARTICLE
Distal catheter lengthening in pediatric patients with hydrocephalus using a guidewire-assisted technique Maria A. Poca 1,2 & Paola Cano 1 Juan Sahuquillo 1,2
&
Francisca Munar 2,3
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Diego González 4 & Katiuska Rosas 1,2
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Received: 6 February 2020 / Accepted: 23 March 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study was to evaluate the lengthening or replacement of the peritoneal catheter in a ventriculoperitoneal shunt by using a simple guidewire-assisted technique. Here we report on our experience with this methodology, its indications, caveats, and contraindications. Methods A prospective study was performed in 59 consecutively shunted children who required elective lengthening of the peritoneal catheter (25 females and 34 males, mean 10.5 + 4.2 years). The procedure required an incision of only 1 cm over the distal catheter. The catheter was sectioned, and a soft hydrophilic guidewire was inserted into the exposed end of it, which serves as a route for the guidewire to reach the intraperitoneal space. The procedure was followed by the replacement of the patient’s catheter with one with additional length as considered appropriate, prior to putting additional slots in the last 5 to 8 cm of the new catheter. Results The technique was used in 62 CSF shunts (3 patients had a double derivative system). Fifty-five of the 62 (89%) procedures performed were effective. A conventional peritoneal opening technique was used in the 7 unsuccessful attempts. One patient presented a migration of the abdominal catheter during the first days after surgery. No incident of peritoneal perforation was associated with this technique, nor were any infections or other early or late complications associated with this surgical procedure. Conclusion The technique we propose permits the peritoneal catheter of a derivative system to be lengthened or replaced in a manner that is simple, fast, and safe. Keywords Distal catheter lengthening . Hydrocephalus . Guidewire . Guidewire-assisted technique . Shunt revision . Ventriculoperitoneal shunt
Introduction The lengthening of the distal catheter in a derivative CSF system is a procedure necessary in some pediatric patients. As they
* Maria A. Poca [email protected] 1
Department of Pediatric Neurosurgery, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
2
Neurotrauma and Neurosurgery Research Unit, Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
3
Pediatric Anesthesiology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
4
Universidad El Bosque, Fundación Santa Fe, Bogotá, Colombia
grow, children with ventriculoperitoneal or ventriculoatrial shunts are followed up with periodic radiographs to assess the length and position of the distal catheter. Usually, distal catheter lengthening is performed on an elective basis. This procedure may involve a complete replacement of the dist
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