Endoscopic Third Ventriculostomy Using Penumbra Artemis™ Neuro Evacuation Device: Technical Case Report and Operative...

Area of Science:

• Neurosurgery
• Minimally Invasive Procedures
• Neuroendoscopy

Background:

• Endoscopic third ventriculostomy (ETV) is a standard treatment for obstructive hydrocephalus.
• A high-riding basilar artery (BA) presents a significant anatomical challenge during ETV, increasing the risk of vascular injury.
• Metastatic brainstem melanoma can cause obstructive hydrocephalus requiring intervention.

Observation:

• A 70-year-old female patient with obstructive hydrocephalus due to brainstem metastases and a high-riding BA was treated.
• The Penumbra Artemis™ Neuro evacuation device was utilized during the ETV procedure.
• The Artemis device was employed to mitigate the risk of injury to the basilar artery.

Findings:

• Successful endoscopic third ventriculostomy (ETV) was performed in a patient with a high-riding basilar artery.
• The use of the Artemis device facilitated the ETV procedure while minimizing the risk to the basilar artery.
• This represents the first reported case of Artemis-assisted ETV in the English literature.

Implications:

• Artemis-assisted ETV may offer a safer alternative for patients with challenging anatomy, such as a high-riding BA.
• This technique could potentially reduce the incidence of basilar artery injury during ETV.
• Further research is warranted to fully evaluate the benefits and limitations of this neurosurgical approach.