J Korean Neurosurg Soc.  2018 Sep;61(5):640-644. 10.3340/jkns.2018.0098.

A Novel Implantable Cerebrospinal Fluid Reservoir : A Pilot Study

• Byun YH
• Gwak HS
• Kwon JW
• Kim KG
• Shin SH
• Lee SH
• Yoo H

• KMID: 2420073
• DOI: http://doi.org/10.3340/jkns.2018.0098

Abstract

OBJECTIVE
The purpose of this pilot study was to examine the safety and function of the newly developed cerebrospinal fluid (CSF) reservoir called the V-Port.
METHODS
The newly developed V-Port consists of a non-collapsible reservoir outlined with a titanium cage and a connector for the ventricular catheter to be assembled. It is designed to be better palpated and more durable to multiple punctures than the Ommaya reservoir. A total of nine patients diagnosed with leptomeningeal carcinomatosis were selected for V-Port insertion. Each patient was followed up for evaluation for a month after the operation.
RESULTS
The average operation time for V-Port insertion was 42 minutes and the average incision size was 6.6 cm. The surgical technique of V-Port insertion was found to be intuitive by all neurosurgeons who participated in the pilot study. There was no obstruction or leakage of the V-Port during intrathecal chemotherapy or CSF drainage. Also, there were no complications including post-operative intracerebral hemorrhage, infection and skin problems related to the V-Port.
CONCLUSION
V-Port is a safe and an easy to use implantable CSF reservoir that addresses problems of other implantable CSF reservoirs. Further multicenter clinical trial is needed to prove the safety and the function of the V-Port.

Keyword

Meningeal carcinomatosis; Intracranial pressure; Drug therapy

MeSH Terms

Catheters
Cerebral Hemorrhage
Cerebrospinal Fluid*
Drainage
Drug Therapy
Humans
Intracranial Pressure
Meningeal Carcinomatosis
Neurosurgeons
Pilot Projects*
Punctures
Skin
Titanium
Titanium

Figure

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  Fig. 1. Photographs of the V-Port. The V-Port is constituted of (A) a noncollapsible reservoir outlined with a titanium cage and (B) a connector for the ventricular catheter to be assembled. (C) The three holes of the titanium outer leaflet are designed to secure the V-Port on the skull using mini screws.

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  Fig. 2. Intraoperative photograph depicting V-Port insertion.

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  Fig. 3. Photographs of CSF being continuously drained. A : A hooked Huber needle was secured in the V-Port. B : The Huber needle was connected to an extra-ventricular drainage bag for continuous drainage of the CSF. CSF : cerebrospinal fluid.

Reference

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