Stent placement for intracranial cysts by combined stereotactic/endoscopic surgery.

Abstract:

OBJECTIVE:The treatment of space-occupying cystic lesions includes percutaneous cyst aspiration, marsupialization, percutaneous ventriculocystotomy, or Rickham catheter implantation. In some patients, the cysts tend to recur and repeated evacuations are necessary. The authors present a new treatment method with internal drainage of cysts into the ventricular system using a balloon-mounted vascular stent. METHODS:Six patients with cysts of low-grade gliomas, one with monocystic craniopharyngioma, and one with suprasellar arachnoid cyst were treated between September 2003 and May 2005. All patients were symptomatic after multiple previous treatments. Stent implantations were performed under local anesthesia in adults and under general anesthesia in children. In all patients, the stereotactic frame and computed tomographic and magnetic resonance fusion were used for an optimized approach. The treatment was performed in a compassionate manner and the patients were informed about the off-label use of the device. RESULTS:Stent placement was successful in all eight patients without procedure-related complications. Improvement of clinical symptoms was seen in seven out of eight patients. Seven out of eight cysts decreased in size within a follow-up period of up to 23 months (mean, 17 mo; median, 18 mo; range, 6-23 mo). The first patient showed recurrence of the tumor cyst 3 months after initial treatment with a Herkulink stent (5 x 18 mm), followed by retreatment with an Omnilink stent (6 x 28 mm; Guidant Corp., Santa Clara, CA). Stenting was ineffective in one patient. CONCLUSION:Treatment of intracranial cystic lesions by internal drainage is possible with the use of stent-assisted ventriculocystostomy.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Berlis A,Vesper J,Ostertag C

doi

10.1227/01.NEU.0000233694.52492.74

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

ONS474-9; discussion ONS479-80

issue

4 Suppl 2

eissn

0148-396X

issn

1524-4040

pii

00006123-200610001-00032

journal_volume

59

pub_type

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