Editorial: Shunt insertion

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Wilson et al.3 have performed a retrospective review of 249 patients who underwent shunt surgery to compare freehand ventricular catheter insertion with ultrasound- and stereotactic-guided insertion. These authors conclude that either stereotactic insertion or ultrasound-guided insertion is more accurate than freehand insertion, but that there is no significant difference in the proportion of shunts needing revision. Among the shunts needing revision, there were fewer ventricular catheter occlusions in patients who underwent ultrasound- or stereotactic-guided insertion.

I find their study results difficult to interpret. They did not state an intended target within the ventricle; accurate shunt placement simply meant

Article Information

Please include this information when citing this paper: published online January 18, 2013; DOI: 10.3171/2012.4.JNS12485.

© AANS, except where prohibited by US copyright law.

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References

1

Hayhurst CBeems TJenkinson MDByrne PClark SKandasamy J: Effect of electromagnetic-navigated shunt placement on failure rates: a prospective multicenter study. Clinical article. J Neurosurg 113:127312782010

2

Kestle JRDrake JMCochrane DDMilner RWalker MLAbbott R III: Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial. J Neurosurg 98:2842902003

3

Wilson TJStetler WR JrAl-Holou WNSullivan SE: Comparison of the accuracy of ventricular catheter placement using freehand placement, ultrasonic guidance, and stereotactic neuronavigation. Clinical article. J Neurosurg [epub ahead of print January 18 2013. DOI: 10.3171/2012.11.JNS111384]

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