title: A hybrid technique for ventriculoatrial shunt implantation--technical note.
abstract: OBJECTIVE
  The aim of the article is to present the new hybrid technique for ventriculoatrial shunt implantation.
  
  
  METHODS
  Two-and-a-half-year-old boy needed ventriculoatrial shunt implantation due to communicating hydrocephalus and impaired absorptive ability of the peritoneum. Because of a complete occlusion of the right internal jugular vein and critical stenosis of a distal part of the left internal jugular vein, the procedure was performed under fluoroscopy guidance in the catheterisation laboratory equipped with a 3-dimensional single plane angiography machine (Philips Allura--The Netherlands). At the level of critical stenosis of the left jugular vein, it was decided to perform a percutaneous venous balloon angioplasty. This procedure allowed inserting the ventriculoatrial shunt into the right atrium.
  
  
  RESULTS
  The whole postoperative period was uneventful. Now, the child is free from symptoms of increased intracranial pressure. The boy has been followed for 9 months. In the control MRI examination, the ventricular system did not change as compared with the previous study.
  
  
  CONCLUSIONS
  The disadvantage of the hemodynamic technique is a higher dose of X-ray irradiation in comparison to other techniques. The hybrid technique should be reserved only to very complicated cases.
authors.affiliation: Polish Mother's Memorial Hospital Research Institute, Rzgowska st 289/281, 93-338, Łódź, Poland, enowos@poczta.onet.pl.
authors.forename: Emilia
authors.initials: E
authors.lastname: Nowosławska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Moszura
authors.forename: Wanda
authors.initials: W
authors.lastname: Mikołajczyk-Wieczorek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zakrzewski
authors.forename: Jacek
authors.initials: J
authors.lastname: Krawczyk
authors.forename: Wojciech
authors.initials: W
authors.lastname: Szymański
authors.forename: Bartosz
authors.initials: B
authors.lastname: Polis
authors.forename: Lech
authors.initials: L
authors.lastname: Polis
mesh_terms: D002404:Catheterization; D002552:Cerebral Ventricles / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D002675:Child, Preschool; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010690:Phlebography; D014057:Tomography, X-Ray Computed