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

Shinya Kobayashi, Tatsuya Ishikawa, Tatsushi Mutoh, Kentaro Hikichi, Akifumi Suzuki

Surgical Neurology International 2012 3(1):119-119

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.

http://www.surgicalneurologyint.com/article.asp?issn=2152-7806;year=2012;volume=3;issue=1;spage=119;epage=119;aulast=Kobayashi

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Júlio Leonardo B. Pereira

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