A 1.2-mm endoscope (Neuropen, Medtronic) has been fed down the lumen of a proximal shunt catheter (Innervision Catheter, Medtronic) and protrudes from its end. Irrigation at a rate of 5 ml/min is being run through the scope. The scope is used to first visualize the bur hole, then the egress point of the old catheter, and finally its parenchymal track. The track is then followed as shown here.
[While site is being updated this video can be viewed on YouTube at this address - https://youtu.be/BtQ_fXjCl54]
The proximal catheter is navigated down the old shunt track under endoscopic guidance. The dark end of the lumen will suddenly begin to lighten, and the ventricle's walls can begin to be appreciated. The scope and catheter are navigated into the ventricle.
[While site is being updated this video can be viewed on YouTube at this address - https://youtu.be/XBi7pb1h45I ]
The catheter is advanced into the ventricle, stopping just short of where the former catheter had been tethered. The scope is then removed.