Document Detail


Intraoperative fiber-optic endoscopy for ventricular catheter insertion.
MedLine Citation:
PMID:  11252296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Ventricular catheter placement is a common neurosurgical procedure often resulting in inaccurate intraventricular positioning. We conducted a comparison of the accuracy of endoscopic and conventional ventricular catheter placement in adults. METHODS: A retrospective analysis of data was performed on 37 consecutive patients undergoing ventriculo-peritoneal shunt (VPS) insertion with endoscopy and 40 randomly selected, unmatched patients undergoing VPS insertion without endoscopy, for the treatment of hydrocephalus of varied etiology. A grading system for catheter tip position was developed consisting of five intraventricular zones, V1 -V5, and three intraparenchymal zones, A, B, C. Zones V1 for the frontal approaches and V1 or V2 for the occipital approaches were the optimal catheter tip locations. Postoperative scans of each patient were used to grade the accuracy of ventricular catheter placement. RESULTS: Seventy-six percent of all endoscopic ventricular catheters were in zone V1 and 100% were within zones V1-V3. No endoscopically inserted catheters were observed in zones V4, V5 or intraparenchymally. Thirty-eight percent of the conventionally placed catheters were in zone V1, 53% in zones V1-3 and 15% intraparenchymally. There was a statistically significant difference in the percentage of catheters in optimal location versus in any other location, favoring endoscopic guidance (p<0.001). CONCLUSION: We conclude that endoscopic ventricular catheter placement provides improved positioning accuracy than conventional techniques.
Authors:
P V Theodosopoulos; A Abosch; M W McDermott
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  28     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-16     Completed Date:  2001-06-21     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  56-60     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, School of Medicine, University of California San Francisco, USA.
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MeSH Terms
Descriptor/Qualifier:
Catheterization / instrumentation,  methods*
Cerebral Ventricles*
Endoscopy*
Female
Fiber Optic Technology
Humans
Hydrocephalus / surgery
Intraoperative Period
Magnetic Resonance Imaging
Male
Middle Aged
Neurosurgical Procedures
Optical Fibers
Retrospective Studies
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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