Lumboperitoneal shunt insertion without fluoroscopy guidance :

Lumboperitoneal (LP) shunts were the mainstay of cerebrospinal Background: fluid diversion therapy for idiopathic intracranial hypertension (IIH). The traditionally cited advantage of LP shunts over ventriculoperitoneal (VP) shunts is the ease of insertion in IIH. This needs to be placed at the level of L3/4 to be below the level of the spinal cord. The objective of this study was to analyse the position of LP shunts inserted without portable fluoroscopy guidance. Methods: A retrospective analysis of radiology was performed for patients who underwent lumboperitoneal shunts between 2006 and 2016 at the National Hospital for Neurology and Neurosurgery. Patients who had insertion of a LP shunt without fluoroscopy guidance were selected. Patients without post-procedural imaging were excluded. A retrospective analysis of the clinical notes was also performed. Results: Between 2006 and 2016, 163 lumboperitoneal shunts were inserted in 105 patients. A total of 56 cases were excluded due to lack of post-procedural imaging; therefore, 107 post-procedural x-rays were reviewed. In 17 (15.8%) cases the proximal end of the LP shunt was placed at L1/L2 level or above. Insertion of LP shunts without portable fluoroscopy guidance Conclusions: gives a 15.8% risk of incorrect positioning of the proximal end of the catheter. We suggest that x-ray is recommended to avoid incorrect level placement. Further investigation could be carried out with a control group with fluoroscopy against patients without. Sabah Al-Rashed ( ) Corresponding author: [email protected] Competing interests: No competing interests were disclosed. Al-Rashed S, Kareem H, Kalra N How to cite this article: et al. Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy 2017, :565 (doi: of placement in a series of 107 procedures [version 1; referees: 3 approved with reservations] F1000Research 6 ) 10.12688/f1000research.11089.1 © 2017 Al-Rashed S . This is an open access article distributed under the terms of the , Copyright: et al Creative Commons Attribution Licence which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Data associated with the article are available under the terms of the (CC0 1.0 Public domain dedication). Creative Commons Zero "No rights reserved" data waiver The author(s) declared that no grants were involved in supporting this work. Grant information: 25 Apr 2017, :565 (doi: ) First published: 6 10.12688/f1000research.11089.1 1 2 2 1 1 1