Role of ventriculoperitoneal shunt valve design in the treatment of pediatric hydrocephalus—a single center study of valve performance in the clinical setting

Beez, Thomas; Sarikaya-Seiwert, Sevgi; Bellstädt, Lina; Mühmer, Mario; Steiger, Hans‐Jakob

doi:10.1007/s00381-013-2244-z

Cited by 20 publications

(8 citation statements)

References 19 publications

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“…Premature infants had a higher risk of shunt failure. 10 Intraventricular hemorrhage (an underlying cause of hydrocephalus), a younger age, and a lower weight at the time of initial shunt placement were shown to be directly correlated with an increased risk of VP shunt failure. 3,10 On the other hand, the case series reported by Miranda et al 2 indicated that rates of shunt obstruction in preterm-related post-hemorrhagic hydrocephalus was high but did not seem to be higher than in other groups with pediatric hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

Incidence of and Causes for Ventriculoperitoneal Shunt Failure in Children Younger Than 2 Years: A Systematic Review

Hasanain

Abdullah

Alsawy

et al. 2018

J Neurol Surg A Cent Eur Neurosurg

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Objectives Ventriculoperitoneal (VP) shunting is commonly used to treat pediatric hydrocephalus, but failure rates are high. VP shunt failure in children is mostly caused by infection and/or proximal/distal shunt obstruction. However, to our knowledge, no previous reviews have discussed this topic using only clinical studies when age-related data could be obtained. This systematic review aimed at reevaluating what is already known as the most common causes of shunt failure and to determine the incidence and causes of VP shunt failure during the first 2 years of life as a step to establish solid evidence-based guidelines to avoid VP shunt failure in infants. Methods We performed a search using the search terms “Cerebrospinal Fluid Shunts” (Medical Subject Headings [MeSH]) AND failure [All Fields] AND (“humans” [MeSH] AND English [lang] AND “infant” [MeSH]). Only articles that specifically discussed VP shunt complications in children < 2 years were included. Results We found that the most common causes of VP shunt failure in children < 2 years were shunt obstruction and infection, both observed in a range. Conclusion VP shunt failure is very common in infants, mostly resulting from obstruction and infection. Future studies should focus on methods designed to avoid these complications or on alternative treatments for hydrocephalus.

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Section: Discussionmentioning

confidence: 99%

Incidence of and Causes for Ventriculoperitoneal Shunt Failure in Children Younger Than 2 Years: A Systematic Review

Hasanain

Abdullah

Alsawy

et al. 2018

J Neurol Surg A Cent Eur Neurosurg

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“…Typically, failure of a fixed-pressure valve system requires valve replacement which is accompanied by the risk of complication. Limiting the need for repeat surgical intervention is a crucial advantage to programmable valves; however, they are accompanied by their own complications [6,10,11], and there is evidence to suggest that shunt survival is not significantly different from that of fixed-pressure valves [12,13]. Given their complex mechanisms, these valves are typically more expensive than their fixed-pressure counterparts, and the debate over the cost-benefit is ongoing [10].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of the Miethke programmable differential pressure valve (proGAV®2.0): a single-centre retrospective analysis

et al. 2021

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Purpose Achieving decompression without CSF over-drainage remains a challenge in hydrocephalus. Differential pressure valves are a popular treatment modality, with evidence suggesting that incorporation of gravitational units helps minimise over-drainage. This study seeks to describe the utility of the proGAV®2.0 programmable valve in a paediatric population. Methods Clinical records and imaging of all patients fitted with proGAV®2.0 valves and Miethke fixed-pressure valves between 2014 and 2019 at our tertiary centre were analysed. Patient demographics, indication for shunt and valve insertion/revision and time to shunt/valve revision were collected. Ventricular linear metrics (fronto-occipital horn ratio (FOHR) and fronto-occipital horn width ratio (FOHWR)) were collected pre- and post-valve insertion. Microsoft Excel and SPSS v24 were used for data collection and statistical analysis. Results Eighty-eight proGAV®2.0 valves were inserted in a population of 77 patients (n = 45 males (58%), mean age 5.1 years (IQR: 0.4–11.0 years)). A total of 102 Miethke fixed-pressure valves were inserted over the same time period. Median follow-up was 17.5 months (1.0–47.3). One (1.1%) proGAV®2.0 was revised due to over-drainage, compared to 2 (1.9%) fixed-pressure valves (p > 0.05). ProGAV®2.0 insertion resulted in a significant decrease in the mean number of revisions per patient per year (1.77 vs 0.25; p = 0.01). Overall shunt system survival with the proGAV®2.0 was 80.4% at 12 months, and mean time to revision was 37.1 months, compared to 31.0 months (95%CI: 25.7–36.3) and 58.3% in fixed-pressure valves (p < 0.01). Significant decreases were seen following proGAV®2.0 insertion in both FOHR and FOHWR, by 0.014 (95%CI: 0.006–0.023, p = 0.002) and 0.037 (95%CI: 0.005–0.069, p = 0.024) respectively. Conclusion The proGAV®2.0 provides effective decompression of hydrocephalic patients, significantly reduces the number of valve revisions per patient and had a significantly greater mean time to revision than fixed-pressure valves.

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“…A wide variety of shunt systems are currently available to clinicians, but their impact on shunt failures rates is unclear. Notarianni et al did not find a difference in the rates of shunt failure in comparing programmable systems with pressure-controlled or valveless shunts, and recent studies with newer valves have not found a difference in revision rates by valve type [2,12]. However, the rates of shunt failure remain high, and new methods are needed to ensure shunt survival [24].…”

Section: Shunt Outcomesmentioning

confidence: 92%

Shunt revision requirements after posthemorrhagic hydrocephalus of prematurity: insight into the time course of shunt dependency

et al. 2015

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Role of ventriculoperitoneal shunt valve design in the treatment of pediatric hydrocephalus—a single center study of valve performance in the clinical setting

Cited by 20 publications

References 19 publications

Incidence of and Causes for Ventriculoperitoneal Shunt Failure in Children Younger Than 2 Years: A Systematic Review

Incidence of and Causes for Ventriculoperitoneal Shunt Failure in Children Younger Than 2 Years: A Systematic Review

Efficacy and safety of the Miethke programmable differential pressure valve (proGAV®2.0): a single-centre retrospective analysis

Shunt revision requirements after posthemorrhagic hydrocephalus of prematurity: insight into the time course of shunt dependency

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