Metal external ventricular drainage catheters in the treatment of persistent ventriculitis - an old story made new: technical note and preliminary results.

AIM: Conventional ventricular catheters have proven to be ineffective in the drainage of the cerebrospinal fluid in the long run in terms of infection rates. Consequently, the development and clinical evaluation of new catheters is urgently needed.

MATERIAL AND

METHODS

We implanted a ventricular needle made of stainless steel in 3 neurosurgical patients in whom multiple conventional (silicon) ventricular catheters had been previously implanted. All of them developed persistent ventriculitis during the first 30 days post-admission. The infection did not respond to antibiotics neither intravenously nor intrathecally via conventional catheters. After the implantation of the needle, colistin mesilate sodium was administered (150,000 IU/day for 21 days) intrathecally, cerebrospinal fluid white blood cells were measured and cerebrospinal fluid cultures were obtained.

RESULTS

Within 15 days after the implantation of the metal catheter, a significant decrease of the cerebrospinal fluid white blood cell count was noted and all cultures were negative. No operation related complications were observed.

CONCLUSION

Our technique of a metal catheter implantation is safe and requires fewer reoperations. Moreover, it is cost-effective since metal catheters can be used for longer periods of time, can be reused in other patients, and are of low cost.