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Surg Neurol Int. 2012;3:119. doi: 10.4103/2152-7806.102330. Epub 2012 Oct 13.

A novel technique for ventriculoperitoneal shunting by flat panel detector CT-guided real-time fluoroscopy.

Author information

  • 1Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-AKITA, Akita, Japan.

Abstract

BACKGROUND:

Surgical placement of a ventriculoperitoneal shunt (VPS) is the main strategy to manage hydrocephalus. However, the failure rate associated with placement of ventricular catheters remains high.

METHODS:

A hybrid operating room, equipped with a flat-panel detector digital subtraction angiography system containing C-arm cone-beam computed tomography (CB-CT) imaging, has recently been developed and utilized to assist neurosurgical procedures. We have developed a novel technique using intraoperative fluoroscopy and a C-arm CB-CT system to facilitate accurate placement of a VPS.

RESULTS:

Using this novel technique, 39 consecutive ventricular catheters were placed accurately, and no ventricular catheter failures were experienced during the follow-up period. Only two patients experienced obstruction of the VPS, both of which occurred in the extracranial portion of the shunt system.

CONCLUSION:

Surgical placement of a VPS assisted by flat panel detector CT-guided real-time fluoroscopy enabled accurate placement of ventricular catheters and was associated with a decreased need for shunt revision.

KEYWORDS:

Cone-beam computed tomography; hydrocephalus; shunt failure; ventriculoperitoneal shunt

PMID:
23226605
[PubMed]
PMCID:
PMC3512332
Free PMC Article

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