Philips M F, Schwartz S B, Soutter A D, Sutton L N
Department of Surgery, Children's Hospital of Philadelphia, Pennsylvania 19104-4399, USA.
J Neurosurg. 1997 Jun;86(6):1063-6. doi: 10.3171/jns.1997.86.6.1063.
Children with shunted hydrocephalus often have a myriad of other medical conditions. When these concomitant problems involve the pleura, peritoneum, and/or the venous system, placement of the distal catheter may prove to be problematic. This report presents preliminary results in three hydrocephalic children following ventriculofemoroatrial shunt placement. The peritoneal and pleural cavities in each of these children were compromised and there was no vascular access into the superior vena cava due to intercurrent disease. An alternative technique for ventriculoperitoneal shunt placement was performed via the femoral vein. Fluoroscopic guidance was used to confirm the intraatrial position of the distal end of the shunt catheter. Follow-up review to date shows no complications. This newly described technique provides a feasible alternative to distal shunt catheter placement in patients in whom more traditional sites are unavailable.
患有分流性脑积水的儿童常常伴有许多其他病症。当这些并发问题累及胸膜、腹膜和/或静脉系统时，远端导管的放置可能会出现问题。本报告介绍了三名脑积水儿童在进行脑室 - 股 - 心房分流术后的初步结果。这些儿童中的每一个的腹膜腔和胸膜腔都存在问题，并且由于并发疾病，无法进入上腔静脉进行血管通路建立。通过股静脉进行了一种替代的脑室 - 腹腔分流术放置技术。使用荧光透视引导来确认分流导管远端的心房内位置。迄今为止的随访复查显示没有并发症。这种新描述的技术为在无法使用更传统部位的患者中进行远端分流导管放置提供了一种可行的替代方法。
