External validation of the ETV success score in 313 pediatric patients: a Brazilian single-center study

Furtado, Leopoldo Mandic Ferreira; Filho, José Aloysio da Costa Val; Júnior, Eustaquio Claret dos Santos

doi:10.1007/s10143-020-01461-6

Cited by 12 publications

(4 citation statements)

References 39 publications

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“…(23) For this reason, ETV should be performed only by experienced neurosurgeons, with precautions taken to avoid leaving excess CSF during the ventricle puncture and throughout the endoscopic navigation. (18,24) The present study reported no upward herniation, and the only intraoperative bleeding was handled by irrigation. To our knowledge, the shunt option has more associated risks.…”

Section: Discussionmentioning

confidence: 43%

“…(4) The ETV success score (ETVSS) is a validated tool that predicts the success of the procedure for all etiologies of hydrocephalus in the first 6-12 months following ETV. (17,18) Our goal in this study was to assess the ability of the ETVSS to predict the success of ETV particularly in the setting of PFT, demonstrating its possible utility in medical decisionmaking for patients with these tumors.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the ETV success score to improve decision making on the management of hydrocephalus secondary to pediatric posterior fossa tumors: A feasibility study

Furtado,

Da Costa Val Filho,

Dantas dos Santos

et al. 2023

Arch Pediat Neurosurg

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Introduction: Hydrocephalus is frequently seen in children with posterior fossa tumors (PFT), and endoscopic third ventriculostomy (ETV) prior to tumor resection can improve surgical conditions by treating the hydrocephalus. Moreover, a scoring system predicting the success of ETV could aid in decision-making for this procedure. Objective: This study aims to evaluate the efficacy of ETV in the treatment of hydrocephalus related to PFT and to evaluate the accuracy of the ETV success score in predicting ETV success. Methods: Patients under 18 years of age who underwent ETV before PFT resection between 1996 and 2021 were included in a retrospective study. The ETV success score was retrospectively obtained for all patients, and its predictive capacity was compared to the actual success observed. Results: Of the 59 surgical cases, a global success rate of 62.7% was observed in the first 6 months following ETV. This rate dropped to 50.8% for those patients reassessed one year after surgery. There was no correlation between the success rate and the histological grade of the tumor or the age of the patient. The ETV success score presented acceptable accuracy at both time points (AUC = 0.671 at 6 months, AUC = 0.649 at one year). Conclusion: ETV proved be a safe procedure, capable of treating hydrocephalus in patients with PFT, and the ETV success score is useful for indicating probable success of the endoscopic procedure.

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Section: Discussionmentioning

confidence: 43%

Section: Introductionmentioning

confidence: 99%

Evaluation of the ETV success score to improve decision making on the management of hydrocephalus secondary to pediatric posterior fossa tumors: A feasibility study

Furtado,

Da Costa Val Filho,

Dantas dos Santos

et al. 2023

Arch Pediat Neurosurg

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“…These risk factors for failure may be related, as the etiologies for hydrocephalus differ in older and younger children, and rates of previous shunting may be related to etiology. These three risk factors have been combined into an Endoscopic Third Ventriculostomy Success Score (ETVSS, Table 1 ), which was designed to predict ETV success at six months postoperatively, but has since been validated in multiple settings and for longer-term outcomes [ 1 , 2 , 36 - 39 ]. In the ETVSS, the score represented the predicted percentage of successful cases.…”

Section: Reviewmentioning

confidence: 99%

Failure of Endoscopic Third Ventriculostomy

Lane¹,

Akbari²

2022

Cureus

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Endoscopic third ventriculostomy (ETV) is an alternative to cerebrospinal fluid (CSF) shunting in the treatment of hydrocephalus. Careful patient selection is critical as patient age, etiology of hydrocephalus, and previous shunting have been shown to influence ETV success rates. Intraoperatively, patient anatomy and medical stability may prevent or limit the completion of the ventriculostomy procedure, and findings such as a patulous third ventricular floor or cisternal scarring may portend a lower chance of successful hydrocephalus treatment. Patients in whom a ventriculostomy is completed may still experience continued symptoms of hydrocephalus or CSF leak, representing an early ETV failure. In other patients, the ETV may prove a durable treatment of hydrocephalus for several months or even years before recurrence of hydrocephalus symptoms. The failure pattern for ETV is different than that of shunting, with a higher early failure rate but improved long-term failure-free survival rates. The risk factors for failure, along with the presentation and management of failure, deserve review.

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“…To predict the success of ETV, Kulkarni et al [26] designed an assessment score based on preoperative variables, such as the patient's age, hydrocephalus etiology, and previous shunt placement, and reached an acceptable level of accuracy in predicting ETV success for the rst six months postoperative, with appropriate reproducibility in various populations worldwide [19,15,34,6,29]. Furthermore, these authors considered a "naked basilar artery," which refers to exposure of the artery during ETV and the subsequent overture of LM as an isolated intraoperative factor for success prediction [27].…”

Section: Introductionmentioning

confidence: 99%

The Role of the Liliequist Membrane in the Third Ventriculostomy

Jacv¹,

SNdS

Lmf

et al. 2021

Preprint

Self Cite

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Endoscopic third ventriculostomy (ETV) is a hydrocephalus treatment procedure that involves opening the Liliequist membrane (LM). However, LM anatomy has not been well-studied neuroendoscopically, because approach angles differ between descriptive and microsurgical anatomical explorations. Discrepancies in ETV efficacy, especially among children age 2 and younger, may be due to incomplete LM opening. The objective of this study was to characterize the LM anatomically from a neuroendoscopic perspective to better understand the impact of anatomical features during LM ostomy and the ETV success rate. Additionally, the ETV success score was tested to predict patient outcome after the intraoperatively difficult opening of LM. Fifty-four patients who underwent ETV were prospectively analyzed with a mean follow-up of 53.1 months (1–90 months). The ETV technical parameters of difficulty were validated by seven expert neurosurgeons. The pediatric population (44) of this study represents the majority of patients (81.4%). The overall ETV success rate was 68.5%. Anomalies on the IIIVT floor resulted in an increased rate of ETV failure. The IIIVT was anomalous, and LM was thick in 33.3% of cases. Fenestration of LM was difficult in 39% of cases, and the LM and TC were opened separately in 55.6% of cases. The endoscopic third ventriculostomy success score (ETVSS) accurately predicted the level of difficulty opening the LM (p = 0.012), and the group with easy opening presented greater durability in ETV success. Neurosurgeons should be aware of the difficulty level of the overture of LM during ETV and its impact on long-term ETV effectiveness.

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External validation of the ETV success score in 313 pediatric patients: a Brazilian single-center study

Cited by 12 publications

References 39 publications

Evaluation of the ETV success score to improve decision making on the management of hydrocephalus secondary to pediatric posterior fossa tumors: A feasibility study

Evaluation of the ETV success score to improve decision making on the management of hydrocephalus secondary to pediatric posterior fossa tumors: A feasibility study

Failure of Endoscopic Third Ventriculostomy

The Role of the Liliequist Membrane in the Third Ventriculostomy

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