[Device for percutaneous insertion of a distal catheter in ventriculo-atrial shunt. Technical report].
OBJECTIVE
A ventriculo-atrial shunt is indicated for the treatment of some hydrocephalus cases. The distal catheter is usually inserted into the right atrium through cervical venous dissection. Percutaneous insertion has been described with success; however its use is not widespread. The aim of this work is to describe modifications in the distal catheter of a ventriculo-atrial shunt, the technique for its percutaneous insertion and the clinical outcome of the process.


METHODS
The distal catheter was modified after its use in 4 animal specimens. It was designed «over the wire», with its flexibility being reduced and accessories being added. The device was subsequently used in humans, with slight modifications of the jugular vein catheterization technique. We evaluated complications, surgical time and outcome during 6months.


RESULTS
In the course of one year, 6adult patients in whom the peritoneum was no longer receiving cerebrospinal fluid were treated for hydrocephalus. The mean operating time was 34minutes (including proximal catheter insertion). There were no complications and ventricular size improved.


CONCLUSIONS
The percutaneous technique has proved useful: it reduces surgical time and has a very low rate of complications. Apparently, modifications made in the distal catheter caused no complications and avoided the use of other materials designed for other purposes. More cases are required to perform a definitive analysis.
Servicio de Neurocirugía, Hospital de Especialidades, Centro Médico Nacional La Raza, Universidad Nacional Autónoma de México, México DF, México.
Jorge Arturo
JA
Santos-Franco
Julio
J
Dávila-Romero
Miguel Antonio
MA
Sandoval-Balanzario
Rafael
R
Saavedra-Andrade
Carlos
C
Rangel-Morales
Oswaldo
O
Escobar-Molina
Ramón
R
López-López
D002557:Cerebrospinal Fluid Shunts; D006325:Heart Atria; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D061646:Operative Time; D019736:Prostheses and Implants; D017287:Ventriculoperitoneal Shunt