Endoscopic Ventricular Catheter Revision – Rick Abbott, M.D.

Introduction of Catheter into Old Track

A 1.2-mm endoscope (Neuropen, Medtronic) has been fed down the lumen of a proximal shunt catheter (Innervision Catheter, Medtronic) and protrudes from its end.  Irrigation at a rate of 5 ml/min is being run through the scope.  The scope is used to first visualize the bur hole, then the egress point of the old catheter, and finally its parenchymal track.  The track is then followed as shown here.

Navigation of Old Track Endoscopically

Video of endoscopically navigating proximal catheter down old catheter tract in brain.

The proximal catheter is navigated down the old shunt track under endoscopic guidance.  The dark end of the lumen will suddenly begin to lighten, and the ventricle’s walls can begin to be appreciated.  The scope and catheter are navigated into the ventricle.

Optimization of Catheter Tip

The catheter is advanced into the ventricle, stopping just short of where the former catheter had been tethered.  The scope is then removed.