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Removal of adherent ventricular catheters by a modified sheath introducer system: technical note
M H Reinges1, V Rohde, T Krings
1Department of Neurosurgery, University of Technology (RWTH), Aachen, Germany.
Background/Purpose:
A series of technical notes has been dedicated to the removal of retained intracranial shunt catheters, among which the intraluminal cautery proved to be the most accepted technique. However, several reports showed that these techniques still harbor potentially serious complications.
Methods:
In this technique, a modified plastic sheath introducer system is passed over the retained ventricular catheter. While advancing the tube along the longitudinal axis of the catheter, circular movements of the tube around the longitudinal axis of the catheter are performed, allowing the tube to act as a spherical knife cutting the ingrown choroid plexus or ependymal adhesions.
Results:
There were no procedure-related complications in any of the 9 patients treated by the technique described. The procedure proved to be easy and effective in all cases. In addition, in case a new ventricular catheter was needed at the same site, it could be placed via the same tube.
Conclusions:
The technique described seems to be an easy, safe, and effective alternative to other techniques for removal of retained ventricular catheters. However, considering the limited number of patients treated with the technique described and the great number of patients treated by the widely accepted intraluminal cautery, one cannot claim the one technique as superior to the other at this stage.