{"id":"b680e655-bdea-43fa-b0a8-5d6b419e675f","slug":"a-novel-technique-for-ventriculoperitoneal-shunting-by-flat-panel-detector-ct-guided-real-time-fluoroscopy","title":"A novel technique for ventriculoperitoneal shunting by flat panel detector CT-guided real-time fluoroscopy","authors":["Shinya Kobayashi","Tatsuya Ishikawa","Tatsushi Mutoh","Kentaro Hikichi","Akifumi Suzuki"],"abstract":"Background: Surgical placement of a ventriculoperitoneal shunt (VPS) is the main strategy to manage hydrocephalus. However, the failure rate associated with placement of ventricular catheters remains high. Methods: A hybrid operating room, equipped with a flat-panel detector digital subtraction angiography system containing C-arm cone-beam computed tomography (CB-CT) imaging, has recently been developed and utilized to assist neurosurgical procedures. We have developed a novel technique using intraoperative fluoroscopy and a C-arm CB-CT system to facilitate accurate placement of a VPS. Results: Using this novel technique, 39 consecutive ventricular catheters were placed accurately, and no ventricular catheter failures were experienced during the follow-up period. Only two patients experienced obstruction of the VPS, both of which occurred in the extracranial portion of the shunt system. Conclusion: Surgical placement of a VPS assisted by flat panel detector CT-guided real-time fluoroscopy enabled accurate placement of ventricular catheters and was associated with a decreased need for shunt revision.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/b680e655-bdea-43fa-b0a8-5d6b419e675f/featured/hero-1782421003399.png","publishDate":"2012-10-13T00:00:00.000Z","doi":"10.4103/2152-7806.102330","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3459/SNI-3-119.pdf"}