Ultrasound guidance for distal insertion of ventriculo-atrial shunt catheters: Technical note

Sameer A. Sheth, Matthew McGirt, Graeme Woodworth, Paul Wang, Daniele Rigamonti

Research output: Contribution to journalArticlepeer-review

Abstract

Ventriculo-atrial (VA) shunts are often used for CSF diversion in situations involving abdominal pathology that preclude the use of ventriculo-peritoneal shunts. Distal (venous) catheters of VA shunts have historically been inserted using a cut-down on the internal jugular vein (IJV). Less invasive placement of atrial catheters may minimize operative times and attenuate postoperative incisional discomfort. We describe a method for atrial catheter placement using ultrasound guidance to visualize the IJV and facilitate percutaneous venous puncture in 17 adult patients (23 total insertions) undergoing treatment for hydrocephalus or pseudotumor cerebri. The IJV and carotid artery were visualized by ultrasound in 23 (100%) cases. Venous penetration and successful atrial catheter placement was achieved on the first attempt in 23 (100%) cases. Pneumothorax, carotid artery puncture or need for venous cut-down occurred in no cases. The utilization of ultrasound guidance for distal VA shunt catheter insertion may increase comfort with this procedure and ultimately decrease complication rate and operative time.

Original languageEnglish (US)
Pages (from-to)280-282
Number of pages3
JournalNeurological research
Volume31
Issue number3
DOIs
StatePublished - Apr 2009

Keywords

  • Cut-down
  • Percutaneous
  • Ultrasound guidance
  • VA shunt
  • Ventriculo-atrial

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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