Previously, the Seldinger technique has been used for insertion of difficult-to-place vascular catheters. The authors describe the use of this technique in exchanging difficult-to-place ventricular catheters in a child with multiloculated hydrocephalus and ventriculoperitoneal shunt infection.Patient and methods
A thin, flexible, hydrophilic catheter (Radifocus Glidewire, Terumo Medical, NJ, USA) was truncated to 35 cm, and the angled tip was transected. This modified wire was then used to cannulate two existing ventricular catheters. Each catheter was exchanged for a ventriculostomy over the glidewire. No complications were observed.Results
Catheter placement was identical to preoperative location on postoperative imaging.Conclusions
The authors believe that the modified Seldinger technique may be of use in selected cases of ventricular catheter exchange. With the increase use of endoscopy to place intracranial catheters, holes in intracranial catheters are more common and, thus, the Seldinger technique may increase in its usage.