The Seldinger technique for insertion of difficult to place ventricular catheters.
BACKGROUND
Multiloculated ventricular hydrocephalus is a difficult pathology for neurosurgeons to treat. Not only are the shunts for this condition prone to malfunction, but they are also difficult to place.


METHODS
The Seldinger technique is used in combination with a rigid scope with a working channel. A soft filiform wire or a thick suture is inserted through the channel. The scope is withdrawn and a ventricular catheter is slid down the wire. The remainder of the shunt is inserted in the usual fashion.


RESULTS
We have not encountered any neurologic compromise from this technique. No bleeding was encountered with the described technique.


CONCLUSIONS
The Seldinger technique with appropriate types of guide wires and in combination with an endoscope is a useful technique for difficult to place shunts.
Lam
Cornelius H
CH
Department of Neurosurgery, University of Minnesota, Minneapolis, Minn 55455, USA. lamxx023@tc.umn.edu
Horrigan
Medina
M
Lovick
Darren S
DS
D002408:Catheters, Indwelling; D014695:Cerebral Ventriculography; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D019723:Endoscopes; D020546:Fourth Ventricle / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D012086:Reoperation / Q000379:methods; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000295:instrumentation*