1 Ocak 2023 Dergi makalesi Açık Erişim

Peiro, Jose L.; Duru, Soner; Fernandez-Tome, Blanca; Peiro, Lucas; Encinas, Jose L.; Sanchez-Margallo, Francisco M.; Oria, Marc

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<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:creator>Peiro, Jose L.</dc:creator>
  <dc:creator>Duru, Soner</dc:creator>
  <dc:creator>Fernandez-Tome, Blanca</dc:creator>
  <dc:creator>Peiro, Lucas</dc:creator>
  <dc:creator>Encinas, Jose L.</dc:creator>
  <dc:creator>Sanchez-Margallo, Francisco M.</dc:creator>
  <dc:creator>Oria, Marc</dc:creator>
  <dc:date>2023-01-01</dc:date>
  <dc:description>BACKGROUND:Congenital obstructive hydrocephalus generates progressive irreversible fetal brain damage by ventricular enlargement and incremental brain tissue compression that leads to maldevelopment and poor clinical outcomes. Intrauterine treatments such as ventriculo-amniotic shunting have been unsuccessfully tried in the eighties.OBJECTIVE:To assess if prenatal endoscopic third ventriculostomy (ETV) is feasible in a large animal model and optimize this technique for ventricular decompression and potential arrest of fetal brain damage in fetal lambs.METHODS:We generated hydrocephalus in 50 fetal lambs by injecting a polymeric agent into the cisterna magna at midgestation (E85). Subsequently, 3 weeks later (E105), fetal ETV was performed using a small rigid fetoscope. The endoscopy entry point was located anterior to the coronal suture, 7 mm from the midline.RESULTS:We obtained clear visualization of the enlarged lateral ventricles by endoscopy in the hydrocephalic fetal lambs. The floor of the third ventricle was bluntly perforated and passed with the scope for a successful ETV. Total success was achieved in 32/50 cases (64%). Causes of failure were blurred vision or third ventricle obliteration by BioGlue in 10/50 (20%) cases, anatomic misdirection of the endoscope in 5 (10%) cases, 2 cases of very narrow foramen of Monro, and 1 case of choroid plexus bleeding. If we exclude the cases artificially blocked by the polymer, we had a successful performance of prenatal-ETV in 80% (32/40) of hydrocephalic fetuses.CONCLUSION:Despite the inherent difficulties arising from ovine brain anatomy, this study shows that innovative fetal ETV is technically feasible in hydrocephalic fetal lambs.</dc:description>
  <dc:identifier>https://aperta.ulakbim.gov.trrecord/265704</dc:identifier>
  <dc:identifier>oai:aperta.ulakbim.gov.tr:265704</dc:identifier>
  <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
  <dc:rights>http://www.opendefinition.org/licenses/cc-by</dc:rights>
  <dc:source>NEUROSURGERY 92(6) 9</dc:source>
  <dc:title>Fetal Endoscopic Third Ventriculostomy Is Technically Feasible in Prenatally Induced Hydrocephalus Ovine Model</dc:title>
  <dc:type>info:eu-repo/semantics/article</dc:type>
  <dc:type>publication-article</dc:type>
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