title: Stereotactic catheter placement for Ommaya reservoirs.
abstract: Ommaya reservoirs are an important surgical therapy for the chronic intrathecal administration of chemotherapy for patients with leptomeningeal carcinomatosis. Surgical accuracy is paramount in these patients with typically normal sized ventricles, and may be improved with stereotactic guidance. This paper aimed to review a large series of stereotactic Ommaya catheter placements, examining accuracy and complications. We conducted a retrospective review of 109 consecutive adult patients who underwent stereotactic Ommaya catheter placement for leptomeningeal carcinomatosis or central nervous system lymphoma at Columbia University Medical Center, USA, from 1998-2013. The rate of accurate placement in the ventricular system was 99%, with the only poor catheter position due to post-placement migration. The rate of peri-operative complications was 6.4%. Hemorrhagic complications occurred in patients with thrombocytopenia or therapeutic anti-coagulation pre-operatively or during the post-operative period. Use of stereotaxy for catheter placement of Ommaya reservoirs is safe and effective, and should be considered when placing a catheter into non-hydrocephalic ventricles.
authors.affiliation: Department of Neurological Surgery, The Neurological Institute, Columbia University, 710 West 168th Street, 4th floor, New York, NY 10032, USA. Electronic address: bck2104@columbia.edu.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Kennedy
authors.affiliation: Department of Neurological Surgery, The Neurological Institute, Columbia University, 710 West 168th Street, 4th floor, New York, NY 10032, USA.
authors.forename: Lauren T
authors.initials: LT
authors.lastname: Brown
authors.affiliation: Department of Neurological Surgery, Miami University, Miami, FL, USA.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Komotar
authors.affiliation: Department of Neurological Surgery, The Neurological Institute, Columbia University, 710 West 168th Street, 4th floor, New York, NY 10032, USA.
authors.forename: Guy M
authors.initials: GM
authors.lastname: McKhann
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D055756:Meningeal Carcinomatosis / Q000188:drug therapy*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents
keywords: Frame-based; Frameless; Ommaya; Stereotaxy