Percutaneous jugular placement of ventriculo-atrial shunts using a split sheath. Technical note

Area of Science:

• Neurosurgery
• Medical Devices

Background:

• Percutaneous ventriculo-atrial (V-A) shunts are used for hydrocephalus treatment.
• Existing techniques often require distal connectors, increasing disconnection risks.

Purpose of the Study:

• To describe and evaluate a new percutaneous V-A shunt insertion technique using a split sheath.
• To assess the safety, efficacy, and operative time of this modified technique.

Main Methods:

• A series of 22 patients underwent percutaneous V-A shunt insertion using a novel split sheath technique.
• The procedure involved fluoroscopic control for catheter placement and confirmation via postoperative radiographs.
• Operating time and complications were recorded.

Main Results:

• The average operating time was 31 minutes.
• The split sheath technique eliminated the need for a distal connector, preventing disconnections.
• All patients showed clinical improvement after a mean follow-up of one year.
• Two instances of carotid artery puncture were managed conservatively.

Conclusions:

• The percutaneous V-A shunt technique with a split sheath is effective and safe for hydrocephalus treatment.
• This method reduces operative time and eliminates risks associated with distal connectors.
• It is recommended for adult hydrocephalus or when the peritoneal cavity is inaccessible in children.