Angiographic catheter: unique tool for neuroendoscopic surgery

Background: Neuroendoscopic removal of intraventricular and juxtaventricular space-occupying lesions (SOL) requires long and thin instruments that can be maneuvered through the compromised working channels. Currently, various rigid and flexible forceps and scissors are being used for this purpose. We present our experience of using cut segment of angiographic, catheters for removal of intraventricular and juxtaventricular SOL by neuroendoscopic surgery. Method: Seventy-one patients having intraventricular and juxtaventricular lesions were excised, decompressed, or biopsied by endoscopic method using angiographic catheters. Lesions were cystic, solid, or mixed cystic and solid. Cystic lesions were aspirated; solid tumors were biopsied, decompressed, or excised by sucking them using 5F to 8F angiographic catheters cut to the length of 30 to 35 cm. Result: Total excision, near total removal, and biopsy of the lesions could be achieved in 14, 19, and 39 patients, respectively; however, in 2 patients of thalamic tumor, the biopsied tissue was negative for tumor. Tumor consistency was the deciding factor for their removal by angiographic catheters; soft lesions were sucked easily, whereas only biopsy could be done in firm and nonsuckable lesions. Major bleeding in a case of craniopharyngiorna was the complication managed by irrigation followed by external ventricular drain. Conclusion: Angiographic catheter is a simple and unique tool for neuroendoscopic surgery. It aids in endoscopic management of diverse intraventricular and juxtaventricular lesions. (c) 2005 Elsevier Inc. All rights reserved.