Mustroph Christian, Saberian Sepehr, Burch Katelyn, Parker Paul, Wrubel David, Sawvel Michael
Neurological Surgery, Emory University, Atlanta, USA.
Neurological Surgery, Morehouse School of Medicine, Atlanta, USA.
Cureus. 2022 Jan 24;14(1):e21555. doi: 10.7759/cureus.21555. eCollection 2022 Jan.
Multiple alternative sites for distal ventriculoperitoneal shunts have been described including pleural, atrial, ureteral, fallopian, and gallbladder placement. In medically complex patients the sites for cerebrospinal fluid (CSF) diversion can be exhausted. We present a case where open retroperitoneal inferior vena cava cannulation was used for successful atrial catheter placement in a 17-month-old female. The patient had a complex abdominal, pulmonary, and vascular history precluding placement of the distal catheter in other sites or atrial placement through more peripheral venous cannulation. The patient underwent uncomplicated open retroperitoneal exposure of her inferior vena cava (IVC) with cannulation and placement of atrial catheter under fluoroscopic guidance. At the follow-up one year after surgery, the patient did not require revision with appropriate placement of the distal atrial catheter.
已经描述了多种用于远端脑室腹腔分流术的替代部位，包括胸膜、心房、输尿管、输卵管和胆囊置入。在病情复杂的患者中，脑脊液（CSF）分流的部位可能会用尽。我们报告了一例17个月大的女性患者，通过开放腹膜后下腔静脉插管成功进行心房导管置入。该患者有复杂的腹部、肺部和血管病史，排除了在其他部位放置远端导管或通过更外周静脉插管进行心房置入的可能性。患者在透视引导下接受了简单的开放腹膜后下腔静脉（IVC）暴露，并进行了插管和心房导管置入。术后一年随访时，患者远端心房导管位置合适，无需翻修。
