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Published on: December 23, 2014
Ultrasound-guided percutaneous brachiocephalic vein cannulation for ventriculoatrial shunt placement in a child
Valentina Baro1, Nicola Zadra2, Luca Sartori3
1Academic Neurosurgery, Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128, Padova, Italy. valentina.baro@unipd.it.
Insights
Percutaneous ventriculoatrial shunt placement in children is now feasible via the right brachiocephalic vein. This approach offers advantages over traditional internal jugular vein cannulation in pediatric patients.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Vascular Access
Background:
- Ventriculoatrial shunt placement is crucial for managing hydrocephalus in children.
- The percutaneous internal jugular vein approach, while common, presents challenges in pediatric patients due to anatomical variations.
- Alternative venous access routes are needed to improve procedural safety and efficacy.
Purpose of the Study:
- To describe a novel percutaneous technique for ventriculoatrial shunt placement in children using the right brachiocephalic vein.
- To evaluate the feasibility and advantages of this alternative approach under intraoperative ultrasonographic guidance.
Main Methods:
- A percutaneous ventriculoatrial shunt was placed in pediatric patients.
- Access was achieved via the right brachiocephalic vein.
- Intraoperative ultrasonography was utilized for guidance throughout the procedure.
Main Results:
- The described technique allows for successful percutaneous ventriculoatrial shunt placement.
- Ultrasonographic control ensures accurate catheter positioning and vessel navigation.
- This method provides a viable alternative to internal jugular vein cannulation.
Conclusions:
- Percutaneous cannulation of the right brachiocephalic vein is a safe and effective method for ventriculoatrial shunt placement in children.
- This approach offers significant advantages in the pediatric population, potentially becoming a preferred method for younger children.
- The use of intraoperative ultrasonography enhances the safety and success rate of the procedure.
Objective:
As far as the ventriculoatrial shunt placement in children is concerned, the percutaneous approach to the internal jugular vein under ultrasonographic control has been hitherto strongly recommended. Unfortunately, children still represent a challenge, having them peculiar characteristics for which the internal jugular vein cannulation shows some disadvantages.
Methods:
In this manuscript, we describe a percutaneous placement of ventriculoatrial shunt via right brachiocephalic vein under intraoperative ultrasonographic control.
Conclusions:
Brachiocephalic vein cannulation in surgery provides notable advantages in paediatric population and it may be considered as the first choice in younger children.
