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Distal catheter lengthening in pediatric patients with hydrocephalus using a guidewire-assisted technique

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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.

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References

  1. Couldwell WT, LeMay DR, McComb JG (1996) Experience with use of extended length peritoneal shunt catheters. J Neurosurg 85:425–427

    Article  CAS  Google Scholar 

  2. Cozzens JW, Chandler JP (1997) Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter. J Neurosurg 87:682–686

    Article  CAS  Google Scholar 

  3. Goldenberg TM, Pritz MB (1992) A simple method for distal catheter lengthening of ventriculoperitoneal shunts. Technical note. J Neurosurg 77:810–811

    Article  CAS  Google Scholar 

  4. Hooper R (1969) A lengthening procedure for ventriculo-atrial shunts. Technical note. J Neurosurg 30:93–96

    Article  CAS  Google Scholar 

  5. Pritz MB (1980) A simple method for distal catheter lengthening of ventriculoatrial shunts. Report of eight cases. J Neurosurg 53:229–232

    Article  CAS  Google Scholar 

  6. Raffa G, D LAT, Conti A, Cardali SM, Angileri FF, Germano A (2017) The efficacy of 90cm-long peritoneal shunt catheters in newborns and infants. J Neurosurg Sci 61:33–38

    PubMed  Google Scholar 

  7. Reynolds JD 3rd (1973) Guide wire technique for revision of ventriculocardiac shunt. Technical note. J Neurosurg 39:121–122

    Article  Google Scholar 

  8. Scott RM (1993) Distal catheter lengthening. J Neurosurg 78:854

    PubMed  CAS  Google Scholar 

  9. Sribnick EA, Sklar FH, Wrubel DM (2015) A novel technique for distal shunt revision: retrospective analysis of guidewire-assisted distal catheter replacement. Neurosurgery 11(Suppl 3):367–370

    PubMed  Google Scholar 

  10. Tepetes K, Tzovaras G, Paterakis K, Spyridakis M, Xautouras N, Hatzitheofilou C (2006) One trocar laparoscopic placement of peritoneal shunt for hydrocephalus: a simplified technique. Clin Neurol Neurosurg 108:580–582

    Article  Google Scholar 

  11. Tulipan N (1993) Distal catheter lengthening. J Neurosurg 78:853–854

    PubMed  CAS  Google Scholar 

  12. Yamada H, Tajima M (1974) A method for lengthening the distal catheter of a Pudenz ventriculoatrial shunt. Technical note. J Neurosurg 40:663–664

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors gratefully acknowledge the collaboration of the nurses in the department of pediatric neurosurgery, especially of Catalina Castro Ocaña and Mónica Castro Fernández.

Funding

This study was partially supported by grant FIS (Fondo de Investigación Sanitaria) PI18/00468, which were co-financed by the European Regional Development Fund (ERDF), awarded to Maria A. Poca.

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Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Maria A. Poca, Paola Cano, Katiuska Rosas & Juan Sahuquillo

  2. Neurotrauma and Neurosurgery Research Unit, Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

    Maria A. Poca, Francisca Munar, Katiuska Rosas & Juan Sahuquillo

  3. Pediatric Anesthesiology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Francisca Munar

  4. Universidad El Bosque, Fundación Santa Fe, Bogotá, Colombia

    Diego González

Authors
  1. Maria A. Poca
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  2. Paola Cano
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  3. Francisca Munar
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  4. Diego González
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  5. Katiuska Rosas
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  6. Juan Sahuquillo
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Contributions

Conception and design: Maria A. Poca. Acquisition of data: Maria A. Poca, Paola Cano, and Diego González. Analysis and interpretation of data: Maria A. Poca, Paola Cano, and Juan Sahuquillo. Drafting the article: Maria A. Poca and Juan Sahuquillo. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the definitive version of the manuscript on behalf of all authors: Maria A. Poca. Study supervision: Maria A. Poca.

Corresponding author

Correspondence to Maria A. Poca.

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Conflict of interest

The authors of this study declare that they have no conflicts of interest with regard to the companies that manufacture and distribute the devices described in this article.

Ethics approval

This study was carried out following the principles of the Declaration of Helsinki. Written informed consent was obtained from the next-of-kin of the patients.

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Poca, M.A., Cano, P., Munar, F. et al. Distal catheter lengthening in pediatric patients with hydrocephalus using a guidewire-assisted technique. Childs Nerv Syst 36, 2733–2740 (2020). https://doi.org/10.1007/s00381-020-04591-w

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  • DOI: https://doi.org/10.1007/s00381-020-04591-w

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