Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure

Jeremiah, Kidola; Cherry, Catherine L.; Wan, Kong-Wah; Toy, Jennifer Ah; Wolfe, Rory; Danks, R. Andrew

doi:10.1016/j.jocn.2015.07.026

Cited by 22 publications

(17 citation statements)

References 26 publications

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“…A study presented by Jeremiah et al [ 6] showed that poor catheter position was substantially more likely to require subsequent shunt revision by Kaplan-Meier survival analysis. Reddy [ 9] demonstrated that adult patients had significantly higher revision-free survival than pediatric patients after their first shunt surgery, and most shunt revisions occurred early, within six months.…”

Section: Discussionmentioning

confidence: 99%

“…Although patients with hydrocephalus significantly benefit from VPS, complications are unavoidable and influence the long-term survival of these patients. Some studies [6][7][8][9] demonstrated that catheter obstruction may be the most common cause of shunt failure. Even experts who perform VPS according to cranial landmarks have certain misplacement rates.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus compared with conventional procedures via the occipital horn

Peng¹,

Zhao²,

Wu³

et al. 2019

Preprint

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Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure for treating hydrocephalus. Catheter obstruction is one of the most common factors influencing patient prognosis. We evaluated the possibility of improving the accuracy of proximal catheter placement and the probable relationship of ventricular catheter obstruction with the symptom grade and postoperative Evans index with intraoperative navigation for VPS compared with conventional surgery via the occipital horn. Method: We performed a retrospective study including 33 patients with VPS in the navigation surgery group and 26 patients with VPS in the conventional surgery group between January 2012 and August 2018. The clinical data, follow-up time, catheterization accuracy, postoperative outcomes, cumulative survival time and correlations of catheter placement with obstruction and of catheter obstruction with the symptom grade and postoperative Evans index were analyzed. Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 patients experienced suboptimal placement (grade 2), and no patients experienced poor ventricular catheter placement (grade 3) in the navigation surgery group compared with 6, 14, and 6 patients, respectively, in the conventional surgery group. Greater improvement in postoperative symptoms (P=0.017) was observed in the navigation surgery group, including less catheter readjustment (P<0.001). Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001). Conclusions: The intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival time was longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus compared with conventional procedures via the occipital horn

Peng¹,

Zhao²,

Wu³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…A study presented by Jeremiah et al [6] showed that according to a Kaplan-Meier survival analysis, a poor catheter position was substantially more likely to require subsequent shunt revision. Reddy [9] demonstrated that adult patients had significantly higher revision-free survival times than pediatric patients after their first shunt surgery and that most shunt revisions occurred early (within six months).…”

Section: Discussionmentioning

confidence: 99%

“…Although patients with hydrocephalus significantly benefit from VPS, complications are unavoidable and influence the long-term survival of these patients. Some studies [6][7][8][9] have demonstrated that catheter obstruction may be the most common cause of shunt failure. Even experts who perform VPS according to cranial landmarks have certain misplacement rates.…”

Section: Introductionmentioning

confidence: 99%

Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus

Peng

Zhao

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure used to treat hydrocephalus. Catheter obstruction is one of the most common factors that influences patient prognosis. We therefore evaluated the accuracy of proximal catheter placement and explored the probable relationship between ventricular catheter obstruction and both symptom grade and postoperative Evans index between an intraoperative navigation system for VPS and conventional surgery via the occipital horn. Methods: We performed a retrospective study of 33 patients with VPS (the navigation surgery group) and 26 patients with VPS (the conventional surgery group) seen between January 2012 and August 2018. The clinical data, follow-up times, catheterization accuracy, postoperative outcomes, cumulative survival times and correlations between catheter placement and obstruction, symptom grade and the postoperative Evans index were analyzed. Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 experienced suboptimal placement (grade 2), and none experienced poor ventricular catheter placement (grade 3) in the navigation surgery group, whereas 6, 14, and 6 patients, respectively, had these results in the conventional surgery group. Greater improvement was observed in postoperative symptoms (P=0.017), including less catheter readjustment (P<0.001), in the navigation surgery group. A Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Moreover, catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001). Conclusions: An intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival times were longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.

show abstract

“…A study presented by Jeremiah et al [6] showed that according to a Kaplan-Meier survival analysis, a poor catheter position was substantially more likely to require subsequent shunt revision. Reddy [9] demonstrated that adult patients had significantly higher revision-free survival times than were found in pediatric patients after their first shunt surgery and that most shunt revisions occurred early, within six months.…”

Section: Discussionmentioning

confidence: 99%

Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus

Peng¹,

Zhao²,

Wu³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure for treating hydrocephalus. Catheter obstruction is one of the most common factors that influences patient prognosis. We evaluated the accuracy of proximal catheter placement and explored the probable relationship between ventricular catheter obstruction and both symptom grade and postoperative Evans index between an intraoperative navigation system for VPS and conventional surgery via the occipital horn. Methods: We performed a retrospective study of 33 patients with VPS (he navigation surgery group) and 26 patients with VPS (the conventional surgery group) seen between January 2012 and August 2018. The clinical data, follow-up times, catheterization accuracy, postoperative outcomes, cumulative survival times and correlations between catheter placement and obstruction, symptom grade and the postoperative Evans index. Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 experienced suboptimal placement (grade 2), and none experienced poor ventricular catheter placement (grade 3) in the navigation surgery group, whereas 6, 14, and 6 patients, respectively, had these results in the conventional surgery group. There was greater improvement in postoperative symptoms (P=0.017), including less catheter readjustment (P<0.001), in the navigation surgery group. Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001). Conclusions: An intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival times were longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.

show abstract

Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure

Cited by 22 publications

References 26 publications

Intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus compared with conventional procedures via the occipital horn

Intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus compared with conventional procedures via the occipital horn

Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus

Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus

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