Removal of a flanged ventricular catheter: illustrative case

BACKGROUNDFlanged ventricular catheters were created in the 1970s to decrease shunt failure by preventing the holes at the catheter tip from contacting the choroid plexus. However, the flanges on the catheter frequently scarred within and tether to the choroid plexus, resulting in higher rates of in...

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Bibliographic Details
Published in:Journal of neurosurgery. Case lessons 2023-08, Vol.6 (8)
Main Authors: Larkin, M. Benjamin, Lazaro, Tyler T., Weiner, Howard L., Whitehead, William E.
Format: Article
Language:English
Subjects:
Case Lesson
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Summary:BACKGROUNDFlanged ventricular catheters were created in the 1970s to decrease shunt failure by preventing the holes at the catheter tip from contacting the choroid plexus. However, the flanges on the catheter frequently scarred within and tether to the choroid plexus, resulting in higher rates of intraventricular hemorrhage when removed. Today, flanged catheters are rarely encountered. OBSERVATIONSThe authors describe an illustrative case of a 7-year-old girl recently adopted from another country with a history of myelomeningocele and shunted hydrocephalus. She had been treated with a flanged catheter at birth. She presented with a shunt infection, which required removal of the flanged catheter tethered to the choroid. LESSONSThe authors illustrate the safe removal of a posterior-entry flanged ventricular catheter tethered to the choroid plexus using monopolar flexible electrocautery. The removal was monitored with a flexible endoscope inserted from an ipsilateral anterior burr hole and was followed by an endoscopic third ventriculostomy.
ISSN:2694-1902
2694-1902
DOI:10.3171/CASE23324