Complications of Cerebrospinal Fluid Diversion (Shunt) Catheters: A Pictorial Essay

Rahalkar, Mukund D

doi:10.1055/s-0037-1599786

Cited by 3 publications

(6 citation statements)

References 21 publications

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“…The studies on shunt dysfunctions are consistent in the general incidence of failure after the initial insertion [12]. Most present approximately 40% in 1 year and 50% in the second year after insertion.…”

Section: Discussionsupporting

confidence: 57%

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Mechanical complications of shunt for hydrocephalus

Melo

2020

APN

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Introduction: Hydrocephalus is the pathology most frequently addressed and studied in pediatric neurosurgery. Over 15,000 new cases are diagnosed each year. Although it is the most common procedure performed by pediatric neurosurgeons, the shunt implant for drainage of cerebrospinal fluid (CSF) also presents the highest rate of failure and replenishment. The last 50 years have been marked by important advances in quality of these implants. However , little has changed regarding the prevalence of these failures. We will comment here the main mechanical failures of the shunt: disconnection, migration, fracture and scraping of the catheter, hollow visceral perforation and distal catheter knot. Methods: Literature review about the main causes of mechanical failure in shunts Conclusion: Shunt dysfunction is still very common, despite technological advances in the treatment of hydrocephalus. Mechanical causes of shunt dysfunction correspond to about 30% of the reasons for changing or overhauling valves. Most of these occur due to surgical problems. Therefore, safe measures reduces these events their clinical features.

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Section: Discussionsupporting

confidence: 57%

“…Long term follow-up data from the Shunt Design Trial demonstrated an overall shunt survival of 41% over 4 years. In another study up to 50% in first year of life and up to 4 to 5% per year thereafter, and as high as 81% after 12 years [12].…”

Section: Discussionmentioning

confidence: 83%

Mechanical complications of shunt for hydrocephalus

Melo

2020

APN

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“…Extrusion of the peritoneal catheter through the abdominal wall is rare [1]. While the proximal portion of the catheter can migrate into the blood [5], it can cause distal complications such as: extrusion of the catheter via umbilical scar [6], abdominal wall, vagina, urethra and anus [9].…”

Section: Etiologymentioning

confidence: 99%

“…Ventriculoperitoneal shunt (VPS) is a neurosurgical intervention indicated for the control and treatment of hydrocephalus [1]. The most common complications of this procedure are: erosion of the skin at the valve site, edema along the catheter path [2], infections [3], malfunction mechanical system [4], disconnection and subdural hematoma [5]. Abdominal complications resulting from the distal catheter are: obstruction of catheter [2], fracture and/or disconnection [5], migration [6], abscess [3], abdominal wall cyst [4], perforations in intestine [3]; bladder [5]; and scrotum [7], and extrusion of the catheter through the vagina [8]; anus [4]; lumbar; and cervical region [6].…”

Section: Introductionmentioning

confidence: 99%

Spontaneous extrusion of the peritoneal catheter through the intact abdominal wall: report of two cases

Pereira¹,

Kalkmann

Aquino³

2021

Arch Pediat Neurosurg

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Introduction: Ventriculoperitoneal shunt (VPS) is a neurosurgical intervention widely used in the control and treatment of hydrocephalus. The migration of the peritoneal catheter through the abdominal wall is an uncommon complication and its pathophysiology is unknown. Patients and Methods: Two cases of the peritoneal catheter extrusion through the abdominal wall are reported in patients with congenital hydrocephalus. Results: Were discovered after removal of the bypass system and systemic antibiotic therapy, followed by replacement of new bypass, with excellent results. Conclusion: In the presence of this complication, surgical treatment is indicated, through complete removal of the system, systemic antibiotic therapy and subsequent replacement of a new system.

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“…8 Other complication includes catheter migration, bowel perforation, pseudocyst formation, subdural hematoma formation, hemiplegia, etc. 9,10 We undertook a prospective data analysis of all the cases of VP shunt surgery over a period of about one and half year done in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, which is a tertiary care center. This single hospital-based epidemiological study, being one of its kind, will hopefully serve the purpose of analyzing various indication and complications of VP shunt surgery in the given population.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study and Analysis of Ventriculoperitoneal Shunt Surgery: Their Indication and Complication in a Single Tertiary Care Center

Pal

Dhar

Sahu

et al. 2021

Indian Journal of Neurosurgery

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Background Ventriculoperitoneal (VP) shunt insertion is routinely performed for the treatment of hydrocephalus due to different indications like congenital, infective, tumor, posttraumatic, and normal pressure hydrocephalus (NPH). A lot of common and rare complications following this procedure have been reported. Objectives To analyze the clinical profile, indications, anesthetic, and postoperative complications for VP shunt surgery in our center. Materials and Methods This prospective clinical review study was conducted in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between October 2018 to January 2020 and included 454 cases of hydrocephalus who underwent VP shunt surgery. The data was compiled and analyzed. Results A total of 454 patients with male predominance were studied. Pediatric and adolescent patients were 48.9% (222/454). Obstructive hydrocephalus due to tumors was the etiology of 48.7% (221/454) cases. The incidence of overall shunt complications was 9.7% (44/454), of which obstruction and infection was 5.9% (27/454) and 3.1% (14/454), respectively. Factors associated with increased shunt complications include redo and infective etiology and cases having higher protein in perioperative cerebrospinal fluid (CSF) analysis. Neuronavigation, antibiotic-impregnated shunt and biventricular shunt are associated with lower complications. Conclusion Obstructive hydrocephalus due to tumors happened to be the most common cause of VP shunt, and shunt obstruction is most common complication, especially in infective and redo cases.

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Complications of Cerebrospinal Fluid Diversion (Shunt) Catheters: A Pictorial Essay

Cited by 3 publications

References 21 publications

Mechanical complications of shunt for hydrocephalus

Mechanical complications of shunt for hydrocephalus

Spontaneous extrusion of the peritoneal catheter through the intact abdominal wall: report of two cases

A Prospective Study and Analysis of Ventriculoperitoneal Shunt Surgery: Their Indication and Complication in a Single Tertiary Care Center

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