BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To ide...BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral extrusion.METHODS An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS complication.Manuscripts were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS complications.The first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December 2022.Cases were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral extrusion.RESULTS A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic review.Group A included n=32,and Group B n=14 cases.Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)cases.Approximately sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned above.In seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt revision.Clinical diagnosis was evident for the entire group A cases.Various diagnostic modalities were used to confirm the diagnosis for Group B cases.Various surgical procedures were offered for the management of the complication in n=43 cases of both Groups.In two instances,intra-gastric migration of the distal VPS catheter was detected during the autopsy.This review documented four deaths.CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups.It was more frequently reported in children,although also reported in adults and older people.A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without transoral extrusion.展开更多
AIM:To evaluate the clinical efficacy of an expanded polytetrafluoro-ethylene-covered Fluency stent compared with that of a polyethylene terephthalate-covered Wallgraft stent for the management of transjugular intrahe...AIM:To evaluate the clinical efficacy of an expanded polytetrafluoro-ethylene-covered Fluency stent compared with that of a polyethylene terephthalate-covered Wallgraft stent for the management of transjugular intrahepatic portosystemic shunt(TIPS)dysfunction.METHODS:A retrospective review of patients who underwent TIPS revision with stent-grafts between May 2007 and June 2011 was conducted.The patients were divided into two groups according to the stentgrafts implanted:the Fluency stent(Bard Incorporated,Karlsruhe,Germany)and the Wallgraft stent(Boston Scientific,Galway,Ireland).The primary patency rates were calculated and compared using the Kaplan-Meier method.RESULTS:A total of 73 patients were evaluated in this study:33 with Fluency stents and 40 with Wallgraft stents.The primary patency rates at 12 and 24 mo were 91% and 85%,respectively,in the Fluency stent group and 78% and 63%,respectively,in the Wallgraft stent group.The primary shunt patency rates after TIPS revision were significantly better with the Fluency stent than with the Wallgraft stent(P = 0.033).CONCLUSION:TIPS revision with the Fluency stent has higher medium-term patency rates than that with the Wallgraft stent.展开更多
文摘BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral extrusion.METHODS An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS complication.Manuscripts were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS complications.The first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December 2022.Cases were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral extrusion.RESULTS A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic review.Group A included n=32,and Group B n=14 cases.Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)cases.Approximately sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned above.In seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt revision.Clinical diagnosis was evident for the entire group A cases.Various diagnostic modalities were used to confirm the diagnosis for Group B cases.Various surgical procedures were offered for the management of the complication in n=43 cases of both Groups.In two instances,intra-gastric migration of the distal VPS catheter was detected during the autopsy.This review documented four deaths.CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups.It was more frequently reported in children,although also reported in adults and older people.A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without transoral extrusion.
基金Supported by National Natural Science Foundation of China,No. 30770984 and No. 81171444
文摘AIM:To evaluate the clinical efficacy of an expanded polytetrafluoro-ethylene-covered Fluency stent compared with that of a polyethylene terephthalate-covered Wallgraft stent for the management of transjugular intrahepatic portosystemic shunt(TIPS)dysfunction.METHODS:A retrospective review of patients who underwent TIPS revision with stent-grafts between May 2007 and June 2011 was conducted.The patients were divided into two groups according to the stentgrafts implanted:the Fluency stent(Bard Incorporated,Karlsruhe,Germany)and the Wallgraft stent(Boston Scientific,Galway,Ireland).The primary patency rates were calculated and compared using the Kaplan-Meier method.RESULTS:A total of 73 patients were evaluated in this study:33 with Fluency stents and 40 with Wallgraft stents.The primary patency rates at 12 and 24 mo were 91% and 85%,respectively,in the Fluency stent group and 78% and 63%,respectively,in the Wallgraft stent group.The primary shunt patency rates after TIPS revision were significantly better with the Fluency stent than with the Wallgraft stent(P = 0.033).CONCLUSION:TIPS revision with the Fluency stent has higher medium-term patency rates than that with the Wallgraft stent.
