Ventriculo-inferior-venacaval shunt salvage via endovascular surgery

• DOI: 10.1080/02688697.2023.2233619
• Publication Date: 2023-07-10T05:49:01Z
• Authors: Megan E. H. Still; Rachel S. F. Moor; Amanda N. Stanton; Justin D. Hilliard; Benjamin N. Jacobs; Lance S. Governale
• Keywords: Salvage Surgery; Endovascular surgery

Hydrocephalus treatment can be very challenging. While some hydrocephalic patients treated endoscopically, many will require ventricular shunting. Frequent shunt issues over a lifetime is not uncommon. Although most malfunctions are of the catheter or valve, distal failures occur as well. A subset accumulate non-functioning drainage sites.We present 27-year-old male with developmental delay who was shunted perinatally for hydrocephalus from intraventricular hemorrhage prematurity. After failure peritoneum, pleura, superior vena cava (SVC), gallbladder, and endoscopy, an inferior (IVC) placed minimally-invasively via common femoral vein. We believe this only eighth reported ventriculo-inferior-venacaval shunt. IVC occlusion years later successfully endovascular angioplasty stenting followed by anticoagulation. To our knowledge, salvaged surgery has been previously described in literature.After SVC, placement option. Subsequent rescued stenting. Anticoagulation after (and potentially initial placement) advised.