Intraoperative ultrasound-guided ventricular cannulation in patients with normal-sized ventricles.

Autor: Unal TC; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey. Electronic address: tugrulcem@gmail.com., Dolas I; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Sahin D; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Gulsever CI; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Dolen D; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Aras Y; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Aydoseli A; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Sabanci PA; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey., Sencer A; Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul Tip Fakultesi, Nörolojik Bilimler Binasi, Fatih/Istanbul 34093, Turkey.
Jazyk: angličtina
Zdroj: Neuro-Chirurgie [Neurochirurgie] 2023 Sep; Vol. 69 (5), pp. 101463. Date of Electronic Publication: 2023 Jun 30.
DOI: 10.1016/j.neuchi.2023.101463
Abstrakt: Introduction: Many pathologies require normal-sized ventricle cannulation, which may be technically challenging even with neuronavigation guidance. This study presents a series of ventricular cannulation of normal-sized ventricles using intraoperative ultrasound (iUS) guidance and the outcomes of patients treated by this technique, for the first time.
Methods: The study included patients who underwent ultrasound-guided ventricular cannulation of normal-sized ventricles (either ventriculoperitoneal (VP) shunting or Ommaya reservoir) between January 2020 and June 2022. All patients underwent iUS-guided ventricular cannulation from the right Kocher's point. The inclusion criteria for normal-sized ventricles were as follows: (1) Evans index <30%, and (2) widest third ventricle diameter <6mm. Medical records and pre-, intra- and post-operative imaging were retrospectively analyzed.
Results: Nine of the 18 included patients underwent VP shunt placement; 6 had idiopathic intracranial hypertension (IIH), 2 had resistant cerebrospinal fluid fistula following posterior fossa surgery, and 1 had iatrogenic intracranial pressure elevation following foramen magnum decompression. Nine patients underwent Ommaya reservoir implantation, 6 of whom had breast carcinoma and leptomeningeal metastases and 3 hematologic disease and leptomeningeal infiltration. All catheter tip positions were achieved in a single attempt, and none were placed suboptimally. Mean follow-up was 10 months. One IIH patient (5.5%) had early shunt infection which necessitated shunt removal.
Conclusion: iUS is a simple and safe method for accurate cannulation of normal-sized ventricles. It provides an effective real-time guidance option for challenging punctures.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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