title: Aqueductal stenting with an intra-catheter endoscope--a technical note.
abstract: BACKGROUND
  Aqueductoplasty as well as aqueductal stenting is an accepted therapy option in short-segment aqueductal stenosis and isolated fourth ventricle. Over the years, different techniques with only slight modifications by using a conventional neuroendoscope with a working sheath to introduce different instruments have been presented. In summary, the use of Fogarty balloon catheters or flexible endoscopes to pass the narrowed aqueduct is recommended.
  
  
  METHODS
  This technical report describes a substantially new technique for this purpose. Six patients underwent aqueductal stenting with a new intracatheter endoscope.
  
  
  RESULTS
  Aqueductal stenting was possible in 4 out of 6 cases. No complications occurred. Handling of this new technique was good and easy without a prolonged learning curve. All four stents did work appropriately, and the procedure was considered to be successful. Of the two failures, the technique was abandoned and endoscopic third ventriculostomy (ETV) was performed in one. In the other case, suboccipital shunting was done.
  
  
  CONCLUSIONS
  This technical report describes a substantially new technique for aqueductal stenting. The combination of an intracatheter miniature endoscope and a prepared ventricular catheter enables careful and elegant aqueductal stenting. Large or flexible endoscopes, balloons, or special instruments to place a stent have become completely obsolete in selected cases.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Antes
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Salah
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Linsler
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany.
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Tschan
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Breuskin
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Kirrberger Straße, Gebäude 90.5, 66421, Homburg, Germany. joachim.oertel@uks.eu.
authors.forename: Joachim
authors.initials: J
authors.lastname: Oertel
mesh_terms: D000293:Adolescent; D000328:Adult; D057785:Catheters; D002535:Cerebral Aqueduct / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D005260:Female; D020546:Fourth Ventricle; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D008875:Middle Aged; D044582:Neuroendoscopes; D044583:Neuroendoscopy / Q000379:methods*; D015607:Stents; D017287:Ventriculoperitoneal Shunt; D014696:Ventriculostomy; D055815:Young Adult
keywords: Aqueductal stenosis; Aqueductal stenting; Aqueductoplasty; Hydrocephalus; Isolated fourth ventricle; Neuroendoscopy