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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Endoscopic stenting utilizing the ventricular catheter in complex hydrocephalus

Meeting Abstract

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  • M.J. Fritsch - Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • C. Müller - Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • S. Langner - Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • M. Kirsch - Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • J. Baldauf - Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
  • H.W.S. Schroeder - Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.07.10

doi: 10.3205/11dgnc154, urn:nbn:de:0183-11dgnc1544

Published: April 28, 2011

© 2011 Fritsch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Complex multicompartment hydrocephalus requires endoscopic fenestrations, multiple ventricular catheters or both. The aim of our study was to evaluate the concept of using one single catheter as a stent between formerly isolated ventricular compartments and as a proximal ventricular catheter of a VP-Shunt.

Methods: We prospectively followed 16 patients, who underwent treatment of complex multicompartment hydrocephalus within a 3 year period between March 2006 and February 2009. All patients underwent a combined treatment consisting of endoscopic fenestration, stent placement and placement of a gravitational shunt (Paedi-GAV, Pro-GAV), utilizing the stent (conventional ventricular catheter / EVD with additional side holes) as the proximal catheter. Patients were followed clinically and with MRI studies.

Results: Endoscopic communication of formerly isolated ventricular compartments was established in all patients. Collapse of the ventricular system was avoided by the gravitational unit and / or the adjustability of the valves. The single proximal catheter / stent served reliably in 13 of the 16 patients as part of the shunt system. Within the follow-up period of 28 months (12–46 months) one shunt revision was required.

Conclusions: The combination of endoscopy with simplification of a pre-existing complex hydrocephalus, the placement of a stent to avoid reclosure of the fenestration sites and placement of gravitational shunt provides long-lasting adequatet treatment. The stent can be utilized safely and reliably as a single proximal ventricular catheter of a VP-Shunt.