PREVENTION OF INTRAVENTRICULAR HEMORRHAGE DURING CSF SHUNT REVISIONS BY MEANS OF A FLEXIBLE COAGULATING ELECTRODE - A PRELIMINARY-REPORT

We report the preliminary results of a prospective study in 19 patient s (22 procedures) undergoing ventricular catheter replacement at the t ime of CSF shunt revision to determine the value of intraluminal coagu lation by means of a flexible monopolar coagulating electrode in preve nting ventricular hemorrhage following catheter removal. These patient s had their first shunt implanted during infancy, and underwent shunt revision during the 1-year period between October 1996 and October 199 7. Sixteen patients were found to have adherent ventricular catheters, that necessitated the use of diathermy for their removal. In 10 proce dures electrocoagulation was applied to the styler of the ventricular catheter thus permitting tube extraction. In the remaining 8 shunt rev isions catheter removal was readily accomplished by coagulation applie d to a flexible monopolar endoscopic electrode introduced into the lum en of the tube. Two patients developed mild intraventricular hemorrhag e following the use of each of the two methods described above. Both c oagulation techniques used during the routine withdrawal of ventricula r catheters seem to be equally effective. The flexible coagulating ele ctrode has the additional advantage over the stylet of being moldable, allowing its use in cases in which the catheter does not follow a str aight course within the ventricular cavity.