Angulation towards coronal convexity measure and catheter length indication improves the quality of ventricular catheter placement – a smartphone-assisted guidance technique.

2021 ◽  
Author(s):  
Philipp Spindler ◽  
Ingo Fiss ◽  
Henrik Giese ◽  
Elvis Hermann ◽  
Johannes Lemcke ◽  
...  
Keyword(s):  
Catheter Placement ◽  
Ventricular Catheter ◽  
Guidance Technique ◽  
Convexity Measure

Sedative effects of alfaxalone and hydromorphone with or without midazolam in cats: a pilot study

2021 ◽  
pp. 1098612X2199615
Author(s):  
Emily P Wheeler ◽  
Amanda L Abelson ◽  
Jane C Lindsey ◽  
Lois A Wetmore
Keyword(s):  
Pilot Study ◽  
Significant Positive Correlation ◽  
Time Correlation ◽  
Catheter Placement ◽  
Blinded Study ◽  
Sedative Effects ◽  
Sedation Scores ◽  
Adult Cats ◽  
To Receive

Objectives The aim of this pilot study was to compare the quality of sedation and ease of intravenous (IV) catheter placement following sedation using two intramuscular (IM) sedation protocols in cats: hydromorphone, alfaxalone and midazolam vs hydromorphone and alfaxalone. Methods This was a prospective, randomized and blinded study. Cats were randomly assigned to receive an IM injection of hydromorphone (0.1 mg/kg), alfaxalone (1.5 mg/kg) and midazolam (0.2 mg/kg; HAM group), or hydromorphone (0.1 mg/kg) and alfaxalone (1.5 mg/kg; HA group). Sedation scoring (0–9, where 9 indicated maximum sedation) was performed at 0, 5, 10, 15 and 20 mins from the time of injection. At 20 mins, an IV catheter placement score (0–10, where 10 indicated least resistance) was performed. Results Twenty-one client-owned adult cats were included in this study. Sedation and IV catheter placement scores were compared between groups using Wilcoxon rank sum tests. Peak sedation was significantly higher ( P = 0.002) in the HAM group (median 9; range 7–9) than in the HA group (median 7; range 3–9), and IV catheter placement scores were significantly higher ( P = 0.001) in the HAM group (median 9.5; range 7–10) compared with the HA group (median 7; range 4–9). Spearman correlations were calculated between IV catheter placement score and sedation scores. There was a significant positive correlation of average sedation over time (correlation 0.83; P <0.001) and sedation at 20 mins (correlation 0.76; P <0.001) with a higher, more favorable IV catheter placement score. Conclusions and relevance These preliminary results suggest that the addition of midazolam to IM alfaxalone and hydromorphone produced more profound sedation and greater ease of IV catheter placement than IM alfaxalone and hydromorphone alone.

scholarly journals Intraoperative Fiber-Optic Endoscopy for Ventricular Catheter Insertion

2001 ◽  
Vol 28 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Philip V. Theodosopoulos ◽  
Aviva Abosch ◽  
Michael W. McDermott
Keyword(s):  
Fiber Optic ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Neurosurgical Procedure ◽  
Significant Difference ◽  
Catheter Tip ◽  
Endoscopic Guidance ◽  
Ventricular Catheters ◽  
Tip Position ◽  
Optic Endoscopy

ABSTRACT:Objective:Ventricular catheter placement is a common neurosurgical procedure often resulting in inaccurate intraventricular positioning. We conducted a comparison of the accuracy of endoscopic and conventional ventricular catheter placement in adults.Methods:A retrospective analysis of data was performed on 37 consecutive patients undergoing ventriculo-peritoneal shunt (VPS) insertion with endoscopy and 40 randomly selected, unmatched patients undergoing VPS insertion without endoscopy, for the treatment of hydrocephalus of varied etiology. A grading system for catheter tip position was developed consisting of five intraventricular zones, V1-V5, and three intraparenchymal zones, A, B, C. Zones V1 for the frontal approaches and V1 or V2 for the occipital approaches were the optimal catheter tip locations. Postoperative scans of each patient were used to grade the accuracy of ventricular catheter placement.Results:Seventy-six percent of all endoscopic ventricular catheters were in zone V1 and 100% were within zones V1-V3. No endoscopically inserted catheters were observed in zones V4, V5 or intraparenchymally. Thirty-eight percent of the conventionally placed catheters were in zone V1, 53% in zones V1-3 and 15% intraparenchymally. There was a statistically significant difference in the percentage of catheters in optimal location versus in any other location, favoring endoscopic guidance (p<0.001).Conclusion:We conclude that endoscopic ventricular catheter placement provides improved positioning accuracy than conventional techniques.

scholarly journals Relationship of the Location of the Ventricular Catheter Tip and Function of the Ventriculoperitoneal Shunt

2019 ◽  
Vol 9 (1) ◽  
pp. 16-21
Author(s):  
DM Arman ◽  
Sheikh Muhammad Ekramullah ◽  
Sudipta Kumer Mukherjee ◽  
Joynul Islam ◽  
Mirza Hafizur Rashid ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Significant Proportion ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Shunt Procedure ◽  
Freehand Technique ◽  
Catheter Tip ◽  
And Function ◽  
Relationship Of ◽  
The Relationship

Object: The objective of this study was to determine the relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt. Methods: This prospective observational study included 140 patients from a single institution who underwent a ventriculoperitoneal shunt procedure in which a new ventricular catheter was placed between September, 2013 and September 2016. Data abstracted for each patient included age, sex, diagnosis, site and side of ventricular catheter placement. Postoperative CT scan images were reviewed for accuracy of ventricular catheter placement. Patients were followed up over 2 ½ to 4 ½ years.63 patients were available for follow up. We lost communication with rest of the patients. The relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt was analyzed in 63 patients. Results: There were 140 patients included in the study; accuracy ventricular catheter tip placement were 55 (39.28%) using freehand technique. VP shunt functioned well in 43 (68.25%) of 63 patients. Among the 43 patients with well functioning shunt ,19 were in accurate group ,7 were in suboptimal group and 17 were in inaccurate group.26 patients (41.27%) had good outcome with normal development and normal IQ Conclusions: Mechanical malfunction and infection are the most significant problems associated with shunts for the treatment of hydrocephalus. Above all, a significant proportion of shunt failure was due to obstruction of the ventricular catheter, and accurate placement of the shunt catheter is highly important to reduce the incidence of shunt malfunction. Bang. J Neurosurgery 2019; 9(1): 16-21

scholarly journals GAVCA Study: Randomized, Multicenter Trial to Evaluate the Quality of Ventricular Catheter Placement with a Mobile Health Assisted Guidance Technique

Neurosurgery ◽  
2017 ◽  
Vol 83 (2) ◽  
pp. 252-262 ◽  
Author(s):  
Ulrich-Wilhelm Thomale ◽  
Andreas Schaumann ◽  
Florian Stockhammer ◽  
Henrik Giese ◽  
Dhani Schuster ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Mobile Health ◽  
Primary Endpoint ◽  
Odds Ratio ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Catheter Position ◽  
Simple Method ◽  
Duration Of Surgery ◽  
Catheter Failure

Abstract BACKGROUND Freehand ventricular catheter placement may represent limited accuracy for the surgeon's intent to achieve primary optimal catheter position. OBJECTIVE To investigate the accuracy of a ventricular catheter guide assisted by a simple mobile health application (mhealth app) in a multicenter, randomized, controlled, simple blinded study (GAVCA study). METHODS In total, 139 eligible patients were enrolled in 9 centers. Catheter placement was evaluated by 3 different components: number of ventricular cannulation attempts, a grading scale, and the anatomical position of the catheter tip. The primary endpoint was the rate of primary cannulation of grade I catheter position in the ipsilateral ventricle. The secondary endpoints were rate of intraventricular position of the catheter's perforations, early ventricular catheter failure, and complications. RESULTS The primary endpoint was reached in 70% of the guided group vs 56.5% (freehand group; odds ratio 1.79, 95% confidence interval 0.89-3.61). The primary successful puncture rate was 100% vs 91.3% (P = .012). Catheter perforations were located completely inside the ventricle in 81.4% (guided group) and 65.2% (freehand group; odds ratio 2.34, 95% confidence interval 1.07-5.1). No differences occurred in early ventricular catheter failure, complication rate, duration of surgery, or hospital stay. CONCLUSION The guided ventricular catheter application proved to be a safe and simple method. The primary endpoint revealed a nonsignificant improvement of optimal catheter placement among the groups. Long-term follow-up is necessary in order to evaluate differences in catheter survival among shunted patients.

Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure

2016 ◽  
Vol 27 ◽  
pp. 95-98 ◽  
Author(s):  
Kealeboga Josephine Jeremiah ◽  
Catherine Louise Cherry ◽  
Kai Rui Wan ◽  
Jennifer Ah Toy ◽  
Rory Wolfe ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Shunt Failure ◽  
Factors Associated ◽  
Modifiable Factors

scholarly journals The accuracy of ventricular catheter placement: does it influence shunt revision rates?

2006 ◽  
Vol 3 (S1) ◽  
Author(s):  
Stephen Price ◽  
Tom Santarius ◽  
Hugh Richards ◽  
Gemma Whiting ◽  
Husam Georges ◽  
...  
Keyword(s):  
Catheter Placement ◽  
Shunt Revision ◽  
Ventricular Catheter

scholarly journals Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 3: Endoscopic computer-assisted electromagnetic navigation and ultrasonography as technical adjuvants for shunt placement

2014 ◽  
Vol 14 (Supplement_1) ◽  
pp. 24-29 ◽  
Author(s):  
Ann Marie Flannery ◽  
Ann-Christine Duhaime ◽  
Mandeep S. Tamber ◽  
Joanna Kemp
Keyword(s):  
Systematic Review ◽  
Task Force ◽  
Catheter Placement ◽  
Computer Assisted ◽  
Ventricular Catheter ◽  
Evidence Based ◽  
Electromagnetic Navigation ◽  
Shunt Placement ◽  
Pediatric Hydrocephalus ◽  
Evidence Based Guidelines

Object This systematic review was undertaken to answer the following question: Do technical adjuvants such as ventricular endoscopic placement, computer-assisted electromagnetic guidance, or ultrasound guidance improve ventricular shunt function and survival? Methods The US National Library of Medicine PubMed/MEDLINE database and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of cerebrospinal fluid shunts for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been delineated a priori were then examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider evidence-based treatment recommendations. Results The search yielded 163 abstracts, which were screened for potential relevance to the application of technical adjuvants in shunt placement. Fourteen articles were selected for full-text review. One additional article was selected during a review of literature citations. Eight of these articles were included in the final recommendations concerning the use of endoscopy, ultrasonography, and electromagnetic image guidance during shunt placement, whereas the remaining articles were excluded due to poor evidence or lack of relevance. The evidence included 1 Class I, 1 Class II, and 6 Class III papers. An evidentiary table of relevant articles was created. Conclusions Recommendation: There is insufficient evidence to recommend the use of endoscopic guidance for routine ventricular catheter placement. Strength of Recommendation: Level I, high degree of clinical certainty. Recommendation: The routine use of ultrasound-assisted catheter placement is an option. Strength of Recommendation: Level III, unclear clinical certainty. Recommendation: The routine use of computer-assisted electromagnetic (EM) navigation is an option. Strength of Recommendation: Level III, unclear clinical certainty.

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