• Abigail J Rao, Zoe Teton, Victor Rodriguez, Brandon H Tieu, and Ahmed M Raslan.
• Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA; Department of Neurosurgery, University of California, Los Angeles, California, USA.
• World Neurosurg. 2019 Jan 1; 121: 24-27.

BackgroundMyelomeningocele 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 DescriptionHere 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.ConclusionsThis 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.Copyright © 2018 Elsevier Inc. All rights reserved.

17 keywords...

hide…