TY - JOUR
T1 - Preventing Ventricular Catheter Displacement and Infection with the “Catheter-Locking Device-Assisted” Technique: A Retrospective Study of 231 Patients
AU - Piccirilli, M.
AU - Scafa, A. K.
AU - Marchese, Enrico
AU - Gallo, M.
AU - Santoro, A.
PY - 2024
Y1 - 2024
N2 - Background: Inserting cerebrospinal fluid diversion devices such as external ventricular drains (EVDs) and ventriculoperitoneal shunts (VPSs) is a critical procedure. Unfortunately, complications such as catheter misplacement, dislocation, or infection can occur. Various surgical strategies aim to reduce these risks. One recent innovation is the “catheter-locking device-assisted” technique for EVD surgery. In this study, we examined its application in a larger group of cases encompassing both EVDs and VPSs over a 30-month period, with a focus on these complications. Methods: All adult patients who underwent a shunt procedure for noninfectious hydrocephalus at our institution from January 2021 to June 2023 were reviewed. We compared complications between those treated with the “standard” technique (subgroup A) and those managed with the “catheter-locking device-assisted” approach (subgroup B). Results: In the EVD surgical group (initial procedures, n = 161), 6 patients (3.7%) required reoperation owing to the catheter misplacement caused by inadvertent migration of the ventricular catheter within the operating room (“early” migration), while 11 patients (6.8%) experienced unintentional postoperative dislodgement (“delayed” migration). Seven patients (4.3%) developed an EVD-related infection after an average duration of 7.4 days. None of these complications were observed in subgroup B patients (P < 0.05). Among VPS patients (n = 137), 4 (2.9%), all in subgroup A, required reoperation due to intraoperative migration of the catheter (P = 0.121); no other complications were identified. Conclusions: The “catheter-locking device-assisted” technique may significantly decrease the occurrence of the most common EVD complications and can also prove beneficial in VPS surgery. However, further investigation is necessary.
AB - Background: Inserting cerebrospinal fluid diversion devices such as external ventricular drains (EVDs) and ventriculoperitoneal shunts (VPSs) is a critical procedure. Unfortunately, complications such as catheter misplacement, dislocation, or infection can occur. Various surgical strategies aim to reduce these risks. One recent innovation is the “catheter-locking device-assisted” technique for EVD surgery. In this study, we examined its application in a larger group of cases encompassing both EVDs and VPSs over a 30-month period, with a focus on these complications. Methods: All adult patients who underwent a shunt procedure for noninfectious hydrocephalus at our institution from January 2021 to June 2023 were reviewed. We compared complications between those treated with the “standard” technique (subgroup A) and those managed with the “catheter-locking device-assisted” approach (subgroup B). Results: In the EVD surgical group (initial procedures, n = 161), 6 patients (3.7%) required reoperation owing to the catheter misplacement caused by inadvertent migration of the ventricular catheter within the operating room (“early” migration), while 11 patients (6.8%) experienced unintentional postoperative dislodgement (“delayed” migration). Seven patients (4.3%) developed an EVD-related infection after an average duration of 7.4 days. None of these complications were observed in subgroup B patients (P < 0.05). Among VPS patients (n = 137), 4 (2.9%), all in subgroup A, required reoperation due to intraoperative migration of the catheter (P = 0.121); no other complications were identified. Conclusions: The “catheter-locking device-assisted” technique may significantly decrease the occurrence of the most common EVD complications and can also prove beneficial in VPS surgery. However, further investigation is necessary.
KW - Complications
KW - External ventricular drain
KW - Ventriculoperitoneal shunt
KW - Infection
KW - Neurosurgical technical advance
KW - Hydrocephalus
KW - Complications
KW - External ventricular drain
KW - Ventriculoperitoneal shunt
KW - Infection
KW - Neurosurgical technical advance
KW - Hydrocephalus
UR - http://hdl.handle.net/10807/304605
U2 - 10.1016/j.wneu.2023.11.089
DO - 10.1016/j.wneu.2023.11.089
M3 - Article
SN - 1878-8750
VL - 182
SP - e236-e244
JO - World Neurosurgery
JF - World Neurosurgery
ER -