{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:18Z","timestamp":1787293458893,"version":"build-2736575974"},"reference-count":40,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Ventriculoperitoneal (VP) shunts are the preferred surgical treatment for hydrocephalus, and rarely, these operations may be complicated by catheter migration to ectopic sites. We present the case of an asymptomatic VP shunt patient with delayed peritoneal catheter migration into the pulmonary artery shunt catheter migration into the pulmonary artery (SCMPA) complicated by knotting and indolent thrombosis, necessitating open-heart surgery for system retrieval.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>We conducted a literature review in PubMed, Scopus, and Web of Science of prior similar reported cases and present the results of 24 cases of SCMPA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>An asymptomatic 12-year-old male presented with SCMPA noted on routine annual follow-up imaging. Preoperative CT angiogram indicated extensive catheter looping into the pulmonary artery without evidence of thrombosis. Less invasive attempts to retrieve the retained catheter were unsuccessful, and open-heart surgery was required. Intraoperatively, a nonocclusive pulmonary arterial thrombus surrounding the knotted catheter was discovered that was lysed successfully before system retrieval.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>VP shunt catheter migration into the pulmonary artery (SCMPA) with concurrent large vessel thrombosis can develop in pediatric patients incidentally without any clinical symptoms. Our report suggests that preoperative CT angiogram may be insufficient to detect arterial thrombosis in the presence of extensive intravascular catheter knotting. An open-chest approach may be the only viable surgical option for catheter retrieval in the presence of complex catheter coiling. The use of anticoagulation following open-heart surgery for retrieval of a migrated VP shunt catheter remains unclear, we here propose that continuation of long-term therapeutic anticoagulation may successfully prevent thrombus relapse.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1150_2021","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T05:59:28Z","timestamp":1646373568000},"page":"77","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Delayed peritoneal shunt catheter migration into the pulmonary artery with indolent thrombosis: A case report and narrative review"],"prefix":"10.25259","volume":"13","author":[{"given":"Mayur S.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Saint Louis University School of Medicine, Saint Louis, Missouri, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin K.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saint Louis University School of Medicine, Saint Louis, Missouri, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Saif Raza","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Alexopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saint Louis University School of Medicine, Saint Louis, Missouri, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maheen Q.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saint Louis University, Saint Louis, Missouri, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe J.","family":"Mercier","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saint Louis University School of Medicine, Saint Louis, Missouri, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna M.","family":"Kemp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saint Louis University School of Medicine, Saint Louis, Missouri, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"10.25259\/SNI_1150_2021\/ref-1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jocn.2015.07.022","article-title":"Risk factors associated with distal catheter migration following ventriculoperitoneal shunt placement","volume":"25","author":"Abode-Iyamah","year":"2016","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_1150_2021\/ref-2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.neuchi.2014.10.109","article-title":"Management of cardiac migration of a distal shunt catheter: The radiological pitfalls","volume":"61","author":"Aboukais","year":"2015","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_1150_2021\/ref-3","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.wneu.2019.12.089","article-title":"Intracardial catheter migration of a ventriculoperitoneal shunt: Pathophysiology and interdisciplinary management","volume":"135","author":"Adib","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1150_2021\/ref-4","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3340\/jkns.2008.44.3.170","article-title":"Upward migration of distal ventriculoperitoneal shunt catheter into the heart: Case report","volume":"44","author":"Chong","year":"2008","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_1150_2021\/ref-5","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.avsg.2017.06.040","article-title":"endovascular retrieval of migrated distal end of ventriculoperitoneal shunt from bilateral pulmonary arteries: A technical note","volume":"45","author":"Dossani","year":"2017","journal-title":"Ann Vasc Surg"},{"key":"10.25259\/SNI_1150_2021\/ref-6","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1038\/jcbfm.2013.95","article-title":"Concomitant analysis of arterial, venous, and CSF flows using phase-contrast MRI: A quantitative comparison between MS patients and healthy controls","volume":"33","author":"ElSankari","year":"2013","journal-title":"J Cereb Blood Flow Metab"},{"key":"10.25259\/SNI_1150_2021\/ref-7","first-page":"206","article-title":"Migration of distal ventriculoperitoneal shunt catheter into the heart. 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