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Preventing Ventricular Catheter Displacement and Infection with the "Catheter-Locking Device-Assisted" Technique: A Retrospective Study of 231 Patients. | LitMetric

AI Article Synopsis

  • Inserting cerebrospinal fluid diversion devices like external ventricular drains (EVDs) and ventriculoperitoneal shunts (VPSs) is essential but carries risks of complications like misplacement and infection.
  • A new technique using a "catheter-locking device" was studied over 30 months to see if it could reduce these risks during surgeries for noninfectious hydrocephalus.
  • Results showed that patients treated with the new technique had no observed complications such as catheter misplacement or infections, whereas those treated with standard methods faced significant issues, indicating the new approach could be more effective, though further research is needed.

Article Abstract

Background: Inserting cerebrospinal fluid diversion devices such as external ventricular drains (EVDs) and ventriculoperitoneal shunts (VPSs) is a critical procedure. Unfortunately, complications such as catheter misplacement, dislocation, or infection can occur. Various surgical strategies aim to reduce these risks. One recent innovation is the "catheter-locking device-assisted" technique for EVD surgery. In this study, we examined its application in a larger group of cases encompassing both EVDs and VPSs over a 30-month period, with a focus on these complications.

Methods: All adult patients who underwent a shunt procedure for noninfectious hydrocephalus at our institution from January 2021 to June 2023 were reviewed. We compared complications between those treated with the "standard" technique (subgroup A) and those managed with the "catheter-locking device-assisted" approach (subgroup B).

Results: In the EVD surgical group (initial procedures, n = 161), 6 patients (3.7%) required reoperation owing to the catheter misplacement caused by inadvertent migration of the ventricular catheter within the operating room ("early" migration), while 11 patients (6.8%) experienced unintentional postoperative dislodgement ("delayed" migration). Seven patients (4.3%) developed an EVD-related infection after an average duration of 7.4 days. None of these complications were observed in subgroup B patients (P < 0.05). Among VPS patients (n = 137), 4 (2.9%), all in subgroup A, required reoperation due to intraoperative migration of the catheter (P = 0.121); no other complications were identified.

Conclusions: The "catheter-locking device-assisted" technique may significantly decrease the occurrence of the most common EVD complications and can also prove beneficial in VPS surgery. However, further investigation is necessary.

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Source
http://dx.doi.org/10.1016/j.wneu.2023.11.089DOI Listing

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