Intrareservoir Administration of Alteplase to Treat a Distal Ventriculoatrial Shunt Obstruction. uri icon

Overview

abstract

  • BACKGROUND: Ventriculoatrial shunts can be afflicted with distal malfunctions due to thrombus formation at the distal tip. Distal tip thrombus formation may occur more commonly in oncologic patients who are predisposed to hypercoagulability. CASE DESCRIPTION: A patient who had a ventriculoatrial shunt placed for leptomeningeal carcinomatosis presented with headaches and confusion and was found to have a partial distal shunt obstruction. Intrareservoir administration of alteplase resulted in resolution of her symptoms. Nuclear medicine shunt patency test demonstrated restoration of distal flow. CONCLUSIONS: Intrareservoir administration of alteplase can be a useful nonoperative treatment strategy for ventriculoatrial shunt malfunction. This strategy may be particularly useful in cases with higher perioperative risk, such as patients with advanced metastatic cancer.

publication date

  • November 9, 2019

Research

keywords

  • Cerebrospinal Fluid Shunts
  • Fibrinolytic Agents
  • Postoperative Complications
  • Tissue Plasminogen Activator

Identity

Scopus Document Identifier

  • 85078504634

Digital Object Identifier (DOI)

  • 10.1016/j.wneu.2019.11.013

PubMed ID

  • 31715416

Additional Document Info

volume

  • 135