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Updated: Jan 29, 2026
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The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects
Published on: October 2, 2014
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Port-a-cath and ventriculoatrial shunt at the same atrium: technical note
Mehmet Can Ezgu1, Cahit Kural1, Salih Guler2
1Department of Neurosurgery, University of Health Sciences, Gulhane Training and Research Hospital, 06010 Etlik, Ankara, Turkey.
Summary
A rare complication of acute lymphoblastic leukemia (ALL), hydrocephalus, was treated with ventriculoatrial (VA) shunting. This case highlights the successful placement of both VP and VA shunt catheters in the right atrium, a first in medical literature.
Area of Science:
- Neuro-oncology
- Pediatric Neurosurgery
- Cardiology
Background:
- Hydrocephalus is a rare but serious complication of acute lymphoblastic leukemia (ALL).
- Standard treatment involves ventriculoperitoneal (VP) shunting, with ventriculoatrial (VA) shunting as a secondary option for VP shunt failure.
- The presence of a port catheter in the right atrium complicates VA shunt placement.
Observation:
- A 4-year-old boy with ALL and hydrocephalus due to ALL brain invasion initially received a VP shunt.
- The VP shunt failed due to an intraabdominal cyst, necessitating an alternative approach.
- VA shunting was performed via the left internal jugular vein.
Findings:
- This is the first reported case of successful ventriculoatrial (VA) shunt placement in a patient with a pre-existing port catheter in the right atrium.
- The procedure involved placing both VP and VA shunt catheters within the right atrium.
- The patient's hydrocephalus was managed following VP shunt failure.
Implications:
- This case demonstrates a viable alternative for managing hydrocephalus in pediatric ALL patients when standard VP shunting fails and a port catheter is present.
- It expands the understanding of shunt placement strategies in complex pediatric neuro-oncology cases.
- Highlights the need for individualized surgical approaches in managing treatment-related complications.
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