Transfemoral vein placement of a ventriculoatrial shunt. Technical note.
Acceptable cavities for the distal portion of a cerebrospinal fluid diversion shunt include the peritoneal, pleural, and atrial cavities. The authors report on a patient in whom placement into the peritoneal cavity failed, the pleural cavity was not an option, and access to the right atrium was not technically possible via standard cannulation techniques into the veins of the neck and shoulder regions. A right ventriculoatrial shunt was thus placed into the right atrium via the ipsilateral femoral vein. Eight months postoperatively, the patient's condition was at baseline and there were no signs of shunt malfunction. This technique may prove useful when other measures have failed.
Tubbs
R Shane
RS
Department of Cell Biology, University of Alabama at Birmingham, Alabama 35233, USA. rstubbs@uab.edu
Barnhart
Douglas
D
Acakpo-Satchivi
Leslie
L
D000293:Adolescent; D000800:Angioplasty, Balloon; D002406:Catheterization, Peripheral / Q000379:methods*; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D005263:Femoral Artery / Q000601:surgery; D005471:Fluoroscopy; D016489:Head Injuries, Closed / Q000150:complications*; D006325:Heart Atria; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D011677:Punctures