Efficacy of three-dimensional rotational fluoroscopic unit guidance for lumbar cerebrospinal fluid drainage among patients with unsuccessful initial attempt at bedside
| Autor: | Tomotaka Ohshima, Shigeru Miyachi, Masakazu Takayasu, Reo Kawaguchi, Taiki Isaji, Naoki Matsuo, Ryuya Maejima |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Subarachnoid hemorrhage Cerebrospinal Fluid Drainage Radiography Interventional Spinal Puncture 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Lumbar medicine Humans In patient Obesity Treatment Failure Minimally invasive procedures Aged Cerebrospinal Fluid Aged 80 and over business.industry Lasers Experiment Model and Techniques Cone-Beam Computed Tomography Subarachnoid Hemorrhage medicine.disease Target site Surgery Computer-Assisted Fluoroscopy Drainage Female Thecal sac Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Interv Neuroradiol |
| ISSN: | 2385-2011 |
| Popis: | Lumbar cerebrospinal fluid drainage has been widely performed in patients at the bedside; however, technical failure can occasionally occur as a result of blind maneuvering. Herein, we present the use of rotational fluoroscopic unit-guided lumbar drainage for patients with an unsuccessful initial attempt at bedside. In four of the 24 patients with aneurysmal subarachnoid hemorrhage, initial lumbar drainage could not be performed at bedside. Thus, a three-dimensional rotational technology guided by a high-quality fluoroscopic unit was used. After a cone-beam computed tomography scan was performed, an accurate puncture point and a target thecal sac were identified using the software. The fluoroscopic unit helped us to identify the puncture point and trajectory with a laser pointer on the patient. A needle was inserted along the tract until the cerebrospinal fluid was collected. The lumbar drainage tube was successfully inserted with a single puncture in all four patients. Rotational fluoroscopic technology helps to identify a suitable puncture point, trajectory and target site for lumbar spinal drainage. Our technique is considerably useful in an era wherein minimally invasive procedures are preferred. |
| Databáze: | OpenAIRE |
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