Letter: Mechanical Complications of Sophysa SM8 Shunt in Adult Hydrocephalus: A Monocentric Experience

Abstract

To the Editor:Recently, we released one of the largest retrospective series studying the ball in cone mechanism of Sophysa in its 2 connectors version (599 implanted patients). 1 We found a global failure rate of 21.9% (131/599). An additional level of reading of the results should be provided. If we analyze the mechanical dysfunction etiologies not of the entire shunt but only of the device, it seems that the intrinsic complication rate of the mechanism of regulation of the opening pressure Sophysa is 3.5% as represented by proximal obstructions (9/599) and over drainages (12/599). Complications related to the double connector with a risk of disconnection are 5.3% (32/599). The 24.4% disconnection rate represents the disconnection rate in all complications (32/131). It therefore seems appropriate to recommend a 1-piece shunt for a primary implantation of Sophysa to reduce the risk of system disconnection by 5.3%. A comparison between 1-piece and 2-piece Sophysa device must be performed to calculate the additional risk associated with the use of this type of device. We also advise centers that treat hydrocephalus to check the risk of using dual connector systems, regardless of the brand of device.