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The Seldinger technique for insertion of difficult to place ventricular catheters
Cornelius H Lam1, Medina Horrigan, Darren S Lovick
1Department of Neurosurgery, University of Minnesota, Minneapolis, Minn 55455, USA. lamxx023@tc.umn.edu
Background:
Multiloculated ventricular hydrocephalus is a difficult pathology for neurosurgeons to treat. Not only are the shunts for this condition prone to malfunction, but they are also difficult to place.
Methods:
The Seldinger technique is used in combination with a rigid scope with a working channel. A soft filiform wire or a thick suture is inserted through the channel. The scope is withdrawn and a ventricular catheter is slid down the wire. The remainder of the shunt is inserted in the usual fashion.
Results:
We have not encountered any neurologic compromise from this technique. No bleeding was encountered with the described technique.
Conclusion:
The Seldinger technique with appropriate types of guide wires and in combination with an endoscope is a useful technique for difficult to place shunts.