3:45 PM Abstract No. 113 Image-guided suprapubic catheter placement using trocar versus Seldinger technique: a comparative analysis of outcomes and complications

Suprapubic catheter placement is a common method of bladder diversion. To date, there are limited reports describing safe placement of large-bore (18–28 F) catheters as smaller catheters often clog and require upsizing procedures. We retrospectively evaluate the image-guided percutaneous placement of large-bore catheters by interventional radiologists in our institution, totaling 51 catheters in 51 patients over 5 years. We successfully placed a large-bore catheter in 96% (49/51) of first attempts with no post-procedural complications. This data demonstrates that percutaneous placement of large-bore suprapubic catheters by interventional radiologists is a safe and less-invasive bladder diversion alternative to traditional blind or open surgical techniques.

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Endoscopic Placement of Fourth Ventricular Catheter Using Seldinger Technique: Description of Technique and Case Series

Operative Neurosurgery ◽

10.1093/ons/opab222 ◽

2021 ◽

Author(s):

Lacey M Carter ◽

Naina L Gross

Keyword(s):

Fourth Ventricle ◽

Intraventricular Hemorrhage ◽

Case Series ◽

Catheter Placement ◽

Seldinger Technique ◽

Ventricular Catheter ◽

Image Guided ◽

History Of ◽

Endoscopic Placement ◽

Endoscopic Fenestration

Abstract BACKGROUND Neonatal intraventricular hemorrhage remains a significant source of morbidity in premature and low-weight patients. Approximately 15% of patients who require cerebrospinal fluid shunting develop trapped fourth ventricle (TFV). Surgical treatment presents challenges with short- and long-term complications. OBJECTIVE To describe a technique that applies the Seldinger technique with image-guided endoscopy for direct visualization of catheter placement. METHODS A guidewire is passed down the endoscope while it is positioned in the fourth ventricle. The endoscope is removed while the guidewire is held in place. The catheter is slid down the guidewire. The guidewire is removed and placement is confirmed with image guidance. RESULTS Three patients, all less than 14 mo old, with history of prematurity and intraventricular hemorrhage with ventriculoperitoneal shunts, presented with loculated hydrocephalus with TFV. They each underwent image-guided endoscopic fenestration of the fourth ventricle with placement of a fourth ventricular catheter performed by our described technique. All 3 patients recovered well and were discharged on postoperative day 1. Follow-up imaging showed decompression of the fourth ventricle and good placement of the fourth ventricular catheter. None have had complications from catheter placement, and one revision of a fourth ventricular catheter was needed, which was completed with the same described technique. CONCLUSION This technique is well suited for cases in which a fourth ventricular catheter or a difficult trajectory catheter is needed during endoscopic fenestration or when distorted anatomy is present that would make a straight trajectory with a pen endoscope more difficult or higher risk.

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Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: clinical results in 78 patients.

Journal of the American Society of Nephrology ◽

10.1681/asn.v31103 ◽

1992 ◽

Vol 3 (1) ◽

pp. 103-107

Author(s):

N S Nahman ◽

D F Middendorf ◽

W H Bay ◽

R McElligott ◽

S Powell ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Catheter Placement ◽

Seldinger Technique ◽

First Episode ◽

Dialysis Access ◽

Peritoneal Dialysis Catheter ◽

Exit Site ◽

Exit Site Infection ◽

Percutaneous Approach ◽

Tunnel Infection

The placement of percutaneous peritoneal dialysis catheters under direct peritoneoscopic visualization is a relatively new technique for establishing peritoneal dialysis access. In this study, in which a modification of the Seldinger technique was used to facilitate the placement of the peritoneoscope, the experience with 82 consecutive catheterization procedures in 78 patients is reported. In 2 (2.4%) of 82 catheterization procedures, we were unable to enter the peritoneal cavity but experienced no other complications unique to the percutaneous approach. Of the 80 successful catheterization procedures, 76 represented first-time catheter placement and constituted a population subjected to life-table analysis examining catheter survival rates, the time to first cutaneous exit site or s.c. tunnel infection, and the time to first episode of peritonitis. After a follow-up period of 50.1 patient yr, 11 catheters were lost because of catheter dysfunction. Other clinical complications included peritoneal fluid leaks at the cutaneous exit site in 11 instances (0.22/patient yr), cutaneous exit site infection in 7 instances (0.14/patient yr), s.c. tunnel infection in 2 instances (0.04/patient yr), and 34 episodes of peritonitis (0.68/patient yr). The results of this study demonstrate that the suggested modification of the percutaneous placement of peritoneal dialysis catheters, under peritoneoscopic visualization, is a viable method for establishing peritoneal access.

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