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Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures
Background: Lumboperitoneal (LP) shunts were the mainstay of cerebrospinal fluid diversion therapy for idiopathic intracranial hypertension (IIH). The traditionally cited advantage of LP shunts over ventriculoperitoneal (VP) shunts is the ease of insertion in IIH. This needs to be placed at the leve...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
F1000Research
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506531/ https://www.ncbi.nlm.nih.gov/pubmed/28751968 http://dx.doi.org/10.12688/f1000research.11089.2 |
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author | Al-Rashed, Sabah Kareem, Haider Kalra, Neeraj D’Antona, Linda Obeidat, Mouness Patel, Bhavesh Toma, Ahmed |
author_facet | Al-Rashed, Sabah Kareem, Haider Kalra, Neeraj D’Antona, Linda Obeidat, Mouness Patel, Bhavesh Toma, Ahmed |
author_sort | Al-Rashed, Sabah |
collection | PubMed |
description | Background: Lumboperitoneal (LP) shunts were the mainstay of cerebrospinal fluid diversion therapy for idiopathic intracranial hypertension (IIH). The traditionally cited advantage of LP shunts over ventriculoperitoneal (VP) shunts is the ease of insertion in IIH. This needs to be placed at the level of L3/4 to be below the level of the spinal cord. The objective of this study was to analyse the position of LP shunts inserted without portable fluoroscopy guidance. Methods: A retrospective analysis of radiology was performed for patients who underwent lumboperitoneal shunts between 2006 and 2016 at the National Hospital for Neurology and Neurosurgery. Patients who had insertion of a LP shunt without fluoroscopy guidance were selected. Patients without post-procedural imaging were excluded. A retrospective analysis of the clinical notes was also performed. Results: Between 2006 and 2016, 163 lumboperitoneal shunts were inserted in 105 patients. A total of 56 cases were excluded due to lack of post-procedural imaging; therefore, 107 post-procedural x-rays were reviewed. In 17 (15.8%) cases the proximal end of the LP shunt was placed at L1/L2 level or above. Conclusions: Insertion of LP shunts without portable fluoroscopy guidance gives a 15.8% risk of incorrect positioning of the proximal end of the catheter. We suggest that x-ray is recommended to avoid incorrect level placement. Further investigation could be carried out with a control group with fluoroscopy against patients without. |
format | Online Article Text |
id | pubmed-5506531 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | F1000Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-55065312017-07-26 Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures Al-Rashed, Sabah Kareem, Haider Kalra, Neeraj D’Antona, Linda Obeidat, Mouness Patel, Bhavesh Toma, Ahmed F1000Res Research Article Background: Lumboperitoneal (LP) shunts were the mainstay of cerebrospinal fluid diversion therapy for idiopathic intracranial hypertension (IIH). The traditionally cited advantage of LP shunts over ventriculoperitoneal (VP) shunts is the ease of insertion in IIH. This needs to be placed at the level of L3/4 to be below the level of the spinal cord. The objective of this study was to analyse the position of LP shunts inserted without portable fluoroscopy guidance. Methods: A retrospective analysis of radiology was performed for patients who underwent lumboperitoneal shunts between 2006 and 2016 at the National Hospital for Neurology and Neurosurgery. Patients who had insertion of a LP shunt without fluoroscopy guidance were selected. Patients without post-procedural imaging were excluded. A retrospective analysis of the clinical notes was also performed. Results: Between 2006 and 2016, 163 lumboperitoneal shunts were inserted in 105 patients. A total of 56 cases were excluded due to lack of post-procedural imaging; therefore, 107 post-procedural x-rays were reviewed. In 17 (15.8%) cases the proximal end of the LP shunt was placed at L1/L2 level or above. Conclusions: Insertion of LP shunts without portable fluoroscopy guidance gives a 15.8% risk of incorrect positioning of the proximal end of the catheter. We suggest that x-ray is recommended to avoid incorrect level placement. Further investigation could be carried out with a control group with fluoroscopy against patients without. F1000Research 2017-06-30 /pmc/articles/PMC5506531/ /pubmed/28751968 http://dx.doi.org/10.12688/f1000research.11089.2 Text en Copyright: © 2017 Al-Rashed S et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Al-Rashed, Sabah Kareem, Haider Kalra, Neeraj D’Antona, Linda Obeidat, Mouness Patel, Bhavesh Toma, Ahmed Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures |
title | Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures |
title_full | Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures |
title_fullStr | Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures |
title_full_unstemmed | Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures |
title_short | Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures |
title_sort | lumboperitoneal shunt insertion without fluoroscopy guidance: accuracy of placement in a series of 107 procedures |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506531/ https://www.ncbi.nlm.nih.gov/pubmed/28751968 http://dx.doi.org/10.12688/f1000research.11089.2 |
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