Distal Ventriculoatrial Shunt Revision in Adult Myelomeningocele Patient Performed via Endovascular Transvenous Approach

Abigail J. Rao, Zoe Teton, Victor Rodriguez, Brandon Tieu, Ahmed Raslan

Research output: Contribution to journalArticle

Abstract

Background: Myelomeningocele patients with shunt-dependent hydrocephalus often require multiple shunt revisions, eventually exhausting first-line distal diversion sites. Ventriculoatrial (VA) shunts are used less commonly than ventriculoperitoneal shunts, but knowledge of their use and complications is important to the neurosurgeon's armamentarium. VA shunts differ from ventriculoperitoneal and ventriculopleural shunts in that the ideal distal catheter target is an anatomically small area in comparison with the peritoneal and pleural cavities. Case Description: Here we present a case of an adult myelomeningocele patient who experienced migration of a distal VA shunt catheter. A minimally invasive revision technique that does not require recannulation of the vessels or open manipulation of the shunt is presented. Conclusions: This is the fourth reported instance of successful distal revision of a migrated VA shunt catheter via transfemoral endovascular snaring. Knowledge of the opportunities afforded by this technique and collaboration with thoracic surgery colleagues is of benefit to all neurosurgeons.

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Keywords

  • Cerebrospinal fluid diversion
  • Endovascular
  • Hydrocephalus
  • Myelomeningocele
  • Revision
  • Ventriculoatrial shunt

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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