Ventriculovascular shunts via the femoral vein: a temporary feasible alternative in pediatric hydrocephalus

Ventriculovascular shunts via the femoral vein have been described as a feasible alternative for cerebrospinal fluid diversion in those complex cases of hydrocephalus in which other accesses are discarded. However, experience is short. To our knowledge, only 4 cases have been reported in the literature to date. We report 2 cases of hydrocephalic children who were developed several complications related to ventriculoperitoneal and ventriculoatrial shunts and who successfully managed by means of ventriculovascular shunts via the femoral vein. Both patients underwent vascular catheter placement through a venotomy performed in the common femoral vein. Catheter advance was controlled under fluoroscopic guidance. Distal catheters were joined by means of a straight connector, and a loop was accommodated in a subcutaneous pocket in the inguinal region to avoid future complications. The femoral vein is a successful alternative approach for distal catheter placement in ventriculovascular shunts when other accesses are ruled out.