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Brain Science Advances 2018, 4(2): 141-155 https://doi.org/10.26599/BSA.2018.9050002
Review Article | Open Access | Issue | Published: 02 April 2019

Mechanisms and major sites of distal catheter migration in ventriculoperitoneal shunting maneuvers: A review article

Show Author's Information Ismatullah Soufiany1,  Khalil Ahmad Hijrat2,  Spina Soufiany3,  Lukui Chen1( )
Department of Neurosurgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
Department of Gynecology/Obstetrics, Mirwais Hospital, School of Medicine, Kandahar University, Kandahar 3802, Afghanistan
Keywords:
ventriculoperitoneal shunt, distal catheter, migration, hydrocephalus
Cite this article:
Soufiany I, Hijrat KA, Soufiany S, et al. Mechanisms and major sites of distal catheter migration in ventriculoperitoneal shunting maneuvers: A review article. Brain Science Advances, 2018, 4(2): 141-155. https://doi.org/10.26599/BSA.2018.9050002
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Abstract Full text About this article

A ventriculoperitoneal shunt (VPS) is a medical device used to deflect cerebrospinal fluid from cerebral ventricles to the peritoneal cavity. Since 1908, ventriculoperitoneal shunts have been considered the best option in hydrocephalus management. Manifestation related to VPS may arise anywhere whilst tunneling the VPS from the ventricle to the peritoneal cavity, but complications associated with the distal catheter are especially common and a leading cause of revision surgeries. Among the many complications associated with peritoneal shunts, migration of the catheter into other parts of the body is still common. Scrotal migration mainly takes place in children aged 4 days to 5 years. Patent processus vaginalis, formation of an inguinal hernia, and increased intraabdominal pressure are leading risk factors associated with migration of the peritoneal catheter into the scrotum. Thoracic migration of peritoneal catheters predominantly occurs in adult patients. Important mechanisms in thoracic migration include (1) iatrogenic perforation of the external or internal jugular veins by the surgeon during tunneling and (2) gradual destruction of the venous structures by the catheter due to routine extension and flexion of the neck. After entering the vessel, negative intrathoracic pressure combined with positive intraabdominal pressure aids migration into the thoracic cavity. Sharp tips or shunt types contribute to intraabdominal migration and perforation.


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About this article

Mechanisms and major sites of distal catheter migration in ventriculoperitoneal shunting maneuvers: A review article

Show Author's information Ismatullah Soufiany1, Khalil Ahmad Hijrat2, Spina Soufiany3, Lukui Chen1( )
Department of Neurosurgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
Department of Gynecology/Obstetrics, Mirwais Hospital, School of Medicine, Kandahar University, Kandahar 3802, Afghanistan

Abstract

A ventriculoperitoneal shunt (VPS) is a medical device used to deflect cerebrospinal fluid from cerebral ventricles to the peritoneal cavity. Since 1908, ventriculoperitoneal shunts have been considered the best option in hydrocephalus management. Manifestation related to VPS may arise anywhere whilst tunneling the VPS from the ventricle to the peritoneal cavity, but complications associated with the distal catheter are especially common and a leading cause of revision surgeries. Among the many complications associated with peritoneal shunts, migration of the catheter into other parts of the body is still common. Scrotal migration mainly takes place in children aged 4 days to 5 years. Patent processus vaginalis, formation of an inguinal hernia, and increased intraabdominal pressure are leading risk factors associated with migration of the peritoneal catheter into the scrotum. Thoracic migration of peritoneal catheters predominantly occurs in adult patients. Important mechanisms in thoracic migration include (1) iatrogenic perforation of the external or internal jugular veins by the surgeon during tunneling and (2) gradual destruction of the venous structures by the catheter due to routine extension and flexion of the neck. After entering the vessel, negative intrathoracic pressure combined with positive intraabdominal pressure aids migration into the thoracic cavity. Sharp tips or shunt types contribute to intraabdominal migration and perforation.

Keywords: ventriculoperitoneal shunt, distal catheter, migration, hydrocephalus

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Publication history

Received: 03 September 2017
Revised: 19 November 2017
Accepted: 05 December 2017
Published: 02 April 2019
Issue date: December 2018

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© The authors 2018

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