Biomedical subjects

C Yepes

Publications and source records attributed to C Yepes.

3 recordsLinked to original sources

PubMed1995

Percutaneous jugular placement of ventriculo-atrial shunts using a split sheath. Technical note.

The percutaneous placement of ventriculo-atrial (V-A) shunts for treatment of hydrocephalus has been previously reported by several authors as a simplified procedure. However, this technique did not avoid the use of a distal connector between the outlet catheter and the atrial one, which may lead to a disconnection. A technique of percutaneous V-A shunt insertion using a split sheath is described and illustrated with a series of 22 patients. The use of a split sheath eliminates any distal connector thus avoiding the risk of shunt disconnection and reducing the operating time. The average operating time was 31 min. This rapid procedure allowed us to operate on two of our patients under local anaesthesia. The correct placement of the atrial catheter tip was performed under fluoroscopic control and always confirmed by postoperative radiographs. Two incidents of carotid artery puncture were controlled by simple local compression without further consequences. The mean follow-up time is one year. All the patients' clinical conditions improved. We are encouraged to use this V-A technique more frequently as a method of choice in the treatment of adult hydrocephalus or when the peritoneal cavity is inaccessible in children. The use of a split sheath is successful in reducing the operating time and avoiding the use of a distal connector.

Adult↗

PubMed1994

[Neurosurgical endoscopy. Diagnostic and therapeutic indications].

An historical review of neurosurgical endoscopy is evocated. The characteristics of the endoscopic material are discussed: flexible or rigid?, length?, diameter?, irrigation?, free-hand manipulation or fixed arm? A rigid neurosurgical endoscope (STORZ) is described which characteristics are the following: 5 mm/3.7 mm ovale diameter, working length of 21 cm (allowing its use under stereotactic conditions), 5F working channel and articulated arm for solid immobilization in the desired position. All the indications of endoscopy are described and illustrated with a series of 48 patients. Indications for diagnosis are rare and summarised in exceptional help for conventional surgery. 80% of the usual indications of endoscopy were represented by third ventriculostomy. The endoscopic guidance brings safety and allows an increasing of the ventriculostomy's indications. Endoscopic fenestrations of arachnoid cyst are described with a particular interest on suprasellar cysts. The other indications are rare: unilateral hydrocephalus, biopsies of intraventricular tumors, puncture of colloid cysts.

Brain Diseases↗

PubMed1992

A technique for stereotactic aspiration of deep intracerebral hematomas under computed tomographic control using a new device.

A new device, modified from the Nucleotome (Surgical Dynamics, Alameda, CA), was used for stereotactic aspiration of deep brain hematomas. Real-time monitoring by computed tomography allows a very safe procedure, and the risk of aspirating the surrounding brain is avoided. The technique was applied in 13 cases of deep brain hematomas. The intraoperative computed tomographic scan demonstrated that the mass effect was always immediately improved. Aspiration was stopped when the midline shift disappeared or was dramatically reduced. For most of the cases, a total aspiration of the hematoma was not needed (mean value of the aspiration rate of 71, 5%). No rebleeding and no complication related to the technique was observed. This technique was easily performed in emergency conditions.

Activities of Daily Living↗