Morbidity of Ventricular Cerebrospinal Fluid Shunt Surgery in Adults: An 8-Year Study

Korinek, Anne‐Marie; Fulla-Oller, Laurence; Boch, Anne‐Laure; Hadiji, Bassem; Puybasset, Louis

doi:10.1227/neu.0b013e318208f360

Cited by 105 publications

(127 citation statements)

References 29 publications

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“…Mechan ical dysfunction remains the most common cause of this failure. 5 The most common reason for proximal catheter failure is believed to be obstruction of the catheter by the choroid plexus; 10 theoretically, optimal catheter placement should help reduce this risk. In pediatric patients, this fac tor has been examined by comparing endoscopically ver sus nonendoscopically placed ventricular catheters.…”

Section: ©Aans 2013mentioning

confidence: 99%

Comparison of the accuracy of ventricular catheter placement using freehand placement, ultrasonic guidance, and stereotactic neuronavigation

Wilson¹,

Stetler²,

Al-Holou³

et al. 2013

JNS

116

108

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Object. The objective of this study was to compare the accuracy of 3 methods of ventricular catheter placement during CSF shunt operations: the freehand technique using surface anatomy, ultrasonic guidance, and stereotactic neuronavigation.Methods. This retrospective cohort study included all patients from a single institution who underwent a ven tricular CSF shunting procedure in which a new ventricular catheter was placed between January 2005 and March 2010. Data abstracted for each patient included age, sex, diagnosis, method of ventricular catheter placement, site and side of ventricular catheter placement, Evans ratio, and bifrontal ventricular span. Postoperative radiographic stud ies were reviewed for accuracy of ventricular catheter placement. Medical records were also reviewed for evidence of shunt failure requiring revision through December 2011. Statistical analysis was then performed comparing the 3 methods of ventricular catheter placement and to determine risk factors for inaccurate placement.Results. There were 249 patients included in the study; 170 ventricular catheters were freehand passed, 51 were placed using stereotactic neuronavigation, and 28 were placed under intraoperative ultrasonic guidance. There was a statistically significant difference between freehand catheters and stereotactic-guided catheters (p < 0.001), as well as between freehand catheters and ultrasound-guided catheters (p < 0.001). The only risk factor for inaccurate place ment identified in this study was use of the freehand technique. The use of stereotactic neuronavigation and ultrasonic guidance reduced proximal shunt failure rates (p < 0.05) in comparison with a freehand technique.Conclusions. Stereotactic-and ultrasound-guided ventricular catheter placements are significantly more accu rate than freehand placement, and the use of these intraoperative guidance techniques reduced proximal shunt failure in this study.

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Section: ©Aans 2013mentioning

confidence: 99%

Comparison of the accuracy of ventricular catheter placement using freehand placement, ultrasonic guidance, and stereotactic neuronavigation

Wilson¹,

Stetler²,

Al-Holou³

et al. 2013

JNS

116

108

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“…However, the advantage of our study was that all patients were managed in highly standardized conditions 36,37 that allowed us to identify clinically relevant independent risk factors. Nevertheless, a prospective and multicenter study featuring different intensive care unit therapeutic strategies should be conducted to confirm the value of this improved score.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

An Admission Bioclinical Score to Predict 1-Year Outcomes in Patients Undergoing Aneurysm Coiling

Degos

Apfel

Sánchez

et al. 2012

Stroke

Self Cite

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Background and Purpose-A number of scores were developed to predict outcomes after clipping for subarachnoidhemorrhages, yet there is no score for patients undergoing endovascular treatment. Our goal was to develop, compare, and validate a predictive score for 1-year outcomes in patients with coiled subarachnoid hemorrhage. Methods-We studied 526 patients for 1 year after intensive care unit discharge. We developed an admission bioclinical score (ABC score), which integrated biomarkers such as troponin I and S100␤, with the Glasgow Coma Scale. Using the receiver operating characteristic curve (95% CI), the ABC score was compared with the Glasgow Coma Scale, World Federation of Neurosurgical Societies score, and Fisher score in the derivation cohort and further validated in an independent cohort. Results-In the derivation cohort (from 2003-2007, nϭ368), multivariate logistic regression analysis showed that only Glasgow Coma Scale (PϽ0.001), high S100␤ (PϽ0.001), and high troponin (PϽ0.02) were independently associated with 1-year mortality. Troponin, S100␤, and Glasgow Coma Scale were thus integrated to derive the ABC score. In the derivation cohort, the ABC score reached an receiver operating characteristic curve of 0.82 (0.77-0.88, PϽ0.001) and was significantly greater than the receiver operating characteristic curves of the Glasgow Coma Scale, World Federation of Neurosurgical Societies, and Fisher scores for predicting 1-year mortality. In the validation cohort (from 2008 -2009, nϭ158), the ABC score's receiver operating characteristic curve of 0.76 (0.67-0.86, PϽ0.001) remained superior to the 3 other scores for predicting 1-year mortality. Conclusions-The ABC score improves 1-year outcome prediction at admission for patients with coiled subarachnoid hemorrhage. Our study provides large cohort-based evidence supporting integration of individual biomarkers and clinical characteristics to predict outcomes. Clinical Trial Registration-URL: www.clinicaltrials.gov. Unique identifier: NCT01357057.

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“…Total shunt revision in our series represented 58.1% of shunt procedures which is much higher than the result of Naftel et Shunt-related infections represent 2 to 27% of total shunt procedures (8,15,18,21,22,28,27,30). Shunt revision due to shunt related infection in our study represented 11.22% of the total cases which is slightly higher than the result of Kulkarni et al (26) who reported 10% infection rate after VPS insertion but less than the results of Kinasha et al (13) who reported 24.6% shunt related infection but overall in our elective neurosurgical procedures the incidence of shunt related infection is still accepted.…”

Section: Discussionmentioning

confidence: 53%

Laparoscopic revision of the distally obstructed ventriculoperitoneal shunt

Abouhashem

Taha²,

Ismail³

et al. 2012

Turkish Neurosurgery

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AIm: Evaluation of the laparoscopic assisted revision of the ventriculoperitoneal shunt as an alternative technique to the traditional laparotomy. mAterIAl and methOds: Out of 1181 elective neurosurgical procedures have been done from January 2009 to December 2010. There are 98 (8.2%) ventriculoperitoneal shunt procedures. New shunt insertion was performed 41 times (41.9%) and shunt revision performed 57 times (58.1%). Shunt-related infection was detected in 11 cases (11.22%) while mechanical failure was found in 46 cases (46.9%), proximal obstruction was diagnosed in 26 cases (26.5 %) while 20 patients (20.4%) suffered from distal obstruction. Out of the 20 patients with distal obstruction, 12 patients were treated with laparoscopic assisted revision of the peritoneal end.results: Intra operative finding revealed peritoneal adhesion in 83.3% of cases and cerebrospinal fluid pseudo cyst in 16.6% while extra peritoneal tube was found in one case. Intraoperative management included adhesiolysis in 10 patient, evacuation and marsupialization of the cyst in two cases in addition to tube repositioning in all cases. There was no procedure-related complications.COnClusIOn: Laparoscopic assisted revision of the peritoneal catheter is an alternative technique to traditional laparotomy in the revision of ventriculoperitoneal shunt.

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Morbidity of Ventricular Cerebrospinal Fluid Shunt Surgery in Adults: An 8-Year Study

Cited by 105 publications

References 29 publications

Comparison of the accuracy of ventricular catheter placement using freehand placement, ultrasonic guidance, and stereotactic neuronavigation

Comparison of the accuracy of ventricular catheter placement using freehand placement, ultrasonic guidance, and stereotactic neuronavigation

An Admission Bioclinical Score to Predict 1-Year Outcomes in Patients Undergoing Aneurysm Coiling

Laparoscopic revision of the distally obstructed ventriculoperitoneal shunt

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