Ommaya Reservoir Related Complications: A Single Center Experience and Review of Current Literature

Abstract

First introduced in 1963, ommaya reservoirs (OmRs) are indwelling intraventricular catheters used for decompression of hydrocephalus, antibiotics, and chemotherapy delivery. They are important alternatives when lumbar punctures are not practical or when long-term administration of medications is needed. Despite being used for over 50 years, placement of these devices can still contribute to significant morbidity and mortality. We performed a single-center retrospective review at the University of Florida Cancer Center evaluating OmR related complications in patients in whom OmR was placed for chemotherapy. We also conducted a systematic review of OmR related and LP complications in setting of chemotherapy delivery. 13 patients met criteria for inclusion in this retrospective study. Time points evaluated for complications were: placement, up to 6 months, 6-12 months, > 12 months, removal and post-discharge. Our institutional data showed a complicated rate of <7% at each time point. For systematic review, 38 studies were reviewed for OmR data, and 8 studies were reviewed for LP data. Infectious complications were more prevalent in OmR studies with statistical significance (p=0.0017), whereas noninfectious complications were more prevalent in LP studies with statistical significance (p=0.0004). This study compared complication rates from infectious and non-infectious sources between patients receiving intrathecal chemotherapy through Ommaya reservoirs versus lumbar puncture. OmR can be very useful in long-term administration of medication, and the relatively high complication rate (especially infectious) can be deemed an acceptable risk for patient population with high morbidity.