title: Accuracy of percutaneous placement of a ventriculoatrial shunt under ultrasonography guidance: a retrospective study at a single institution.
abstract: The authors report their experience using preoperative chest radiography and intraoperative ultrasonography for percutaneous positioning of the distal end of the catheter when placing ventriculoatrial (VA) shunts in patients with hydrocephalus. The distal portion of VA shunt catheters were percutaneously placed into the internal jugular vein with the aid of intraoperative ultrasonography in 14 consecutive adults. In all cases, the technique was easy, there were no postoperative complications, and postoperative chest radiography demonstrated good positioning of the distal catheter tip. One patient presented with a shunt infection and needed a shunt replacement. The authors therefore conclude that percutaneous placement of a VA shunt under preoperative radiographic guidance and ultrasonographic monitoring is a safe, effective, and reliable technique that is simple to learn.
authors.affiliation: Departments of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Metellus
authors.forename: Wesley
authors.initials: W
authors.lastname: Hsu
authors.forename: Siddharth
authors.initials: S
authors.lastname: Kharkar
authors.forename: Sumit
authors.initials: S
authors.lastname: Kapoor
authors.forename: William
authors.initials: W
authors.lastname: Scott
authors.forename: Daniele
authors.initials: D
authors.lastname: Rigamonti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D007432:Intraoperative Period; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D012189:Retrospective Studies; D014463:Ultrasonography; D014696:Ventriculostomy