A Brief Review of Ventriculoatrial and Ventriculopleural Shunts

Yerragunta, Thirumal; Manda, V; Yerramneni, VamshiKrishna; Kanala, RamNath Reddy

doi:10.4103/0028-3886.332248

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…1) Medtronic Strata VA, 2) Codman Hakim VA, 3) Sophysa Polaris VA and 4) Integra Pudenz VA Ventriculopleural (VPL) shunt works by draining excess CSF from the ventricles of the brain into the pleural cavity around the lungs, where it is then absorbed by the lymphatic system. [32][33][34] The VPL shunt consists of several components, including a catheter, a valve, and a connector. The catheter is inserted into the ventricles of the brain and then tunnelled under the skin to the chest.…”

Section: Low-profile Vp Shuntmentioning

confidence: 99%

An overview of hydrocephalus and shunts used in the clinical management of hydrocephalus

Jakiela,

Billavara,

Kaliaperumal

et al. 2023

Preprint

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<p>As hydrocephalus is a complex neurological condition with significant clinical implications, we believe that this review article is timely to provide a comprehensive overview of shunts used in neurosurgery. This article delves into the etiology, clinical presentation, and challenges associated with hydrocephalus, while focusing primarily on the surgical placement of shunt systems as a key management strategy. We believe that this review will offer valuable insights to clinicians and researchers involved in the management of hydrocephalus. It will provide an in-depth understanding of different shunt systems, their specific characteristics, and associated advantages and limitations, thus empowering clinicians to make informed decisions tailored to individual patients.</p>

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Section: Low-profile Vp Shuntmentioning

confidence: 99%

An overview of hydrocephalus and shunts used in the clinical management of hydrocephalus

Jakiela,

Billavara,

Kaliaperumal

et al. 2023

Preprint

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show abstract

“…This shunt works by draining excess CSF from the ventricles of the brain into the pleural cavity around the lungs, where it is then absorbed by the lymphatic system [32][33][34]. The VPL shunt consists of several components, including a catheter, a valve, and a connector.…”

Section: Ventriculo-pleural (Vpl) Shuntmentioning

confidence: 99%

An Overview of Hydrocephalus and Shunts Used in The Clinical Management of Hydrocephalus

2023

JNS

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Hydrocephalus is a complex neurological condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain, leading to increased intracranial pressure. The clinical management of hydrocephalus often involves the surgical placement of a shunt system to divert CSF and restore normal fluid dynamics. This article provides a comprehensive overview of hydrocephalus, its etiology, clinical presentation, and various types of shunts used in its management. The outline of this report encompasses the principles of shunt surgery, indications for shunt placement and primary types of shunts used in the clinical management of hydrocephalus, including ventriculoperitoneal (VP), ventriculoatrial (VA), ventriculopleural (VPL), lumboperitoneal (LP) and ventriculo-subgaleal (VS) shunts. Additionally, some non-conventional shunts such as ventriculo-osseous, ventriculo renal, ventriculo gall bladder, intraventricular (Aqueductal stents) and long-tunnelled external ventricular drains are also discussed. The distinct features of each shunt type, its associated advantages, limitations and complications are also outlined together with a comparison between pressure vs flow regulated valves. An understanding of the different shunt types and their specific characteristics is essential for clinicians to make informed decisions in tailoring treatment to individual patients. This review offers a comprehensive understanding of shunt characteristics which we believe will empower clinicians to make informed decisions tailored to individual patients, ensuring effective CSF diversion and long-term management of hydrocephalus.

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“…Hydrocephalus is mostly treated by surgical implantation of a valved shunt system to drain the CSF from the ventricles to a speci c drainage spot [4][5][6]. Nowadays, ventriculo-peritoneal (VP) shunt with CSF drainage intraabdominally and ventriculo-atrial (VA) shunt with CSF drainage into the right cardiac atrium are mainly used [7]. In the history of hydrocephalus treatment, alternative drainage locations were also evaluated.…”

Section: Introductionmentioning

confidence: 99%

Valve pressure adjustments of cerebrospinal fluid shunts – longitudinal analysis of 614 patients

Schön

Krigers

Klingenschmid

et al. 2023

Preprint

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Background The implantation of a cerebrospinal fluid (CSF) shunt is one of the most common interventions in neurosurgery. However, there is a high rate of re-interventions e.g., surgical revisions, changes of valve pressure or radiological examinations. Various operating techniques, shunt valves and settings have been used in the past decades. Our goal was to investigate the clinical and technical characteristics influencing the need for intervention. Methods 614 patients between 2000 and 2019 which were treated surgically or seen as out-patients with a CSF-shunt dependent hydrocephalus at our department were longitudinally analyzed. Interventions were defined as any change in valve pressure setting or revision surgery. The clinical and technical data were retrospectively collected and analyzed using integrated regression and cox regression. Results 289 (47.1%) male and 325 (52.9%) female patients with a median age of 61 years (IqR: 47 – 70), with 441 (71.9%) ventriculoperitoneal shunts (VP) and 150 (24.4%) ventriculoatrial shunts, 351 (57.7%) programmable and 257 (42.3%) non-programmable shunts were documented. The median follow-up was 53.9 months (CI95%: 47.5 – 60.2, range: 0 – 463). Female patients were looked after significantly longer (60.0 months, CI95% 50.9 - 69.1). The average time until the first intervention was 98 months (IqR: 81.8 – 115.2). Gender, height, weight and BMI did not influence the need for earlier intervention. In long-term follow-up, valve pressure which never needed an intervention was influenced by the type of the shunt (VA or VP) and the programmability of the valve. Gender, height, weight and BMI had no impact on the pressure setting. Conclusion The individual pressure setting with none to fewer interventions is influenced by the programmability of the CSF-shunt, the age of the patient and the shunt-type. Gender, height, weight and BMI are not clinically relevant to identify the ideal valve pressure.

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A Brief Review of Ventriculoatrial and Ventriculopleural Shunts

Cited by 5 publications

References 20 publications

An overview of hydrocephalus and shunts used in the clinical management of hydrocephalus

An overview of hydrocephalus and shunts used in the clinical management of hydrocephalus

An Overview of Hydrocephalus and Shunts Used in The Clinical Management of Hydrocephalus

Valve pressure adjustments of cerebrospinal fluid shunts – longitudinal analysis of 614 patients

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