Vianney Gilard1, Nicolas Magne2, Emmanuel Gerardin2, Sophie Curey3, Valérie Pelletier4, Pierre Hannequin3, Stéphane Derrey5. 1. Department of Neurosurgery, Rouen University Hospital, Rue de Germont, Rouen, France; Department of Radiology, Rouen University Hospital, Rue de Germont, Rouen, France; Microvascular Endothelium and Neonate Brain Lesions Laboratory, INSERM ERI 28, Faculty of medecine, Rouen, France. Electronic address: vianneygilard@hotmail.fr. 2. Department of Radiology, Rouen University Hospital, Rue de Germont, Rouen, France. 3. Department of Neurosurgery, Rouen University Hospital, Rue de Germont, Rouen, France. 4. Department of Pharmacy, Rouen University Hospital, Rue de Germont, Rouen, France. 5. Department of Neurosurgery, Rouen University Hospital, Rue de Germont, Rouen, France; Department of Radiology, Rouen University Hospital, Rue de Germont, Rouen, France; Microvascular Endothelium and Neonate Brain Lesions Laboratory, INSERM ERI 28, Faculty of medecine, Rouen, France; Department of Pharmacy, Rouen University Hospital, Rue de Germont, Rouen, France; Nutrition, Gut and Brain Laboratory, INSERM UMR1073, Faculty of Medecine, Rouen, France.
Abstract
OBJECTIVE: Optimal ventricular catheter positioning is able to reduce the risk of catheter dysfunction, and subsequently the risk of multiple revision surgery. The objective of our study was to compare the proportion of optimal ventricular catheter placements in a cohort of patients operated for ventriculoperitoneal (VP) shunt between a free-hand group and a neuronavigated group. PATIENTS AND METHODS: Twenty patients with hydrocephalus requiring VP shunt were prospectively included in this study. Patients were divided into two groups; the ventricular catheter was positioned using free-hand method (n=10) or magnetic navigation system (n=10). For the two groups, clinical baseline characteristics, etiology of hydrocephaly and initial ventricular size were assessed. The main judgment criterion was the proportion of optimal catheter placements defined by the presence of all catheter holes in the ventricle, evaluated on post-operative CT scan. RESULTS: There was no initial difference between the two groups in terms of hydrocephalus etiology or initial ventricular size. The number of optimal catheter placements was 6/10 in the neuronavigated group versus 1/10 in the free-hand group (p<0.05). There were no complications during post-operative period in either cohort. CONCLUSION: In patients suffering from hydrocephaly, the use of an electromagnetic neuronavigation system for ventricular catheter placement significantly improved the proportion of optimal catheter placements. Long-term follow-up is necessary to evaluate the number of revision surgeries and the cost in each group.
OBJECTIVE: Optimal ventricular catheter positioning is able to reduce the risk of catheter dysfunction, and subsequently the risk of multiple revision surgery. The objective of our study was to compare the proportion of optimal ventricular catheter placements in a cohort of patients operated for ventriculoperitoneal (VP) shunt between a free-hand group and a neuronavigated group. PATIENTS AND METHODS: Twenty patients with hydrocephalus requiring VP shunt were prospectively included in this study. Patients were divided into two groups; the ventricular catheter was positioned using free-hand method (n=10) or magnetic navigation system (n=10). For the two groups, clinical baseline characteristics, etiology of hydrocephaly and initial ventricular size were assessed. The main judgment criterion was the proportion of optimal catheter placements defined by the presence of all catheter holes in the ventricle, evaluated on post-operative CT scan. RESULTS: There was no initial difference between the two groups in terms of hydrocephalus etiology or initial ventricular size. The number of optimal catheter placements was 6/10 in the neuronavigated group versus 1/10 in the free-hand group (p<0.05). There were no complications during post-operative period in either cohort. CONCLUSION: In patients suffering from hydrocephaly, the use of an electromagnetic neuronavigation system for ventricular catheter placement significantly improved the proportion of optimal catheter placements. Long-term follow-up is necessary to evaluate the number of revision surgeries and the cost in each group.