Aqueductal Stent Placement:Indications, Technique And Clinical Experience

Objective:Although aqueduct stent placement (ASP), as a curative and radical procedure is well known, comprehensive and detailed reports on ASP, including indications, approach and clinical result are lacking in the literature.Method:We retrospectively analyzed a series of 10 consecutive patients who were judged to be suitable for ASP on the basis of the etiology of hydrocephalus, MRI features and intra-operative findings between February 2009 and May 2014, focusing on indications, technique and clinical experience.Results:Totally 10 patients were judged to be suitable for ASP (mean age 38 years, range5 months-69 years). Eight patients harbored an obstructive hydrocephalus caused by aqueductal stenosis. The underlying pathology consisted of intra-ventricular tumor in 3 cases, intra-ventricular cysticercosis in 2 cases and membranous or inflammatory obstruction in 3 cases. Two patients presented a trapped fourth ventricle (TFV) resulted from Dandy-Walker malformation and shunt placement to treat a post-infectious hydrocephalus respectively. Aqueduct stents were placed endoscopically in 8 cases while the other 2 were placed microscopically. There were no deaths due to ASP. All of the patients showed improvement or resolution of their pre-operative symptoms. After an average follow-up period of 27 months (range1-51months), recurrence of aqueductal stenosis has not been observed. In one patient, there was a complication of transient oculomotor paralysis after ASP. A stent migration was observed in one patient after maintaining stable for about 4 years.Conclusion:ASP is technically feasible and can be useful in selected patients either through endoscopic or open surgery.