Rate and Risk Factors of Early Ventriculoperitoneal Shunt Revision: A Five-Year Retrospective Analysis of a Referral Center

Ahmadvand, Saba; Dayyani, Mojtaba; Etemadrezaie, Hamid; Ghorbanpour, Ahmad; Zarei, Reyhaneh; Shahriyari, Ali; Emadzadeh, Maryam; Ganjeifar, Babak; Zabihyan, Samira

doi:10.1016/j.wneu.2019.10.108

Cited by 17 publications

(18 citation statements)

References 34 publications

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“…The most common complications in the cohort were shunt blockade )45.94%(, and shunt infection )16.21%(. Ahmadvand S, et al 7 retrospectively studied 82 patients with 121 revisions, the most common complication reported was obstruction of the shunts )53.6%(. Agarwal N et al 9 retrospectively studied complications of VP shunt in 41 hydrocephalus patients and 47 complications.…”

Section: All the Included Patients Required One Or More Shuntmentioning

confidence: 99%

“…Ahmadvand S et al 7 retrospectively studied 30-day shunt failure rate in 82 patients 71% of whom belonged to the pediatrics age group with 121 revisions. The following risk factors were studied: age, gender, household income, level of education, cause of hydrocephalus, causes of revision, type of failure, anatomic site, duration of operation, time of surgery, surgeons' level of expertise, and Glasgow Coma Scale )GCS( score.…”

Section: All the Included Patients Required One Or More Shuntmentioning

confidence: 99%

“…Our results are comparable to what was previously reported, where it was reported that congenital hydrocephalus was the most common cause with its rate ranging from 36.5%-47%. 6,7 Our study was limited by its retrospective nature and the small sample size, as only patients with a VP shunt revision in our institution with complete detailed documentation in a single institute. We recommend a multi-center study with a larger sample size to confirm the current findings.…”

Section: All the Included Patients Required One Or More Shuntmentioning

confidence: 99%

“…3 The most common complication necessitating revision are obstruction, infection, and displacement. 2,3,6,7 Shunt failure is most common within the first 2 years postoperatively. 3 Many important predictors of VP shunt failure have been reported in the literature, including etiologies of the hydrocephalus, prematurity, and age at the initial placement of the shunt.…”

mentioning

confidence: 99%

“…1,8,9 Clinical factors that may increase the risk of shunt revision include time from the first surgery, surgical procedure duration, prior treatments, number of surgeons, surgical expertise, surgical technique, anatomic site of the shunt, and diagnosis. 1,[7][8][9][10] Proximal catheter tip location is another predictor, as tip positions in the Foramen of Monro, lateral ventricles, or the third ventricle all were associated with lower rates of surgical revision. 11 Other predictors of shunt failure were reported to be poor catheter placement and use of a non-programmable valve.…”

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confidence: 99%

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Patterns and prognosis of Ventriculoperitoneal shunt malfunction among pediatrics in Saudi Arabia

Altwejri

AlRaddadi

Alsager

et al. 2020

NSJ

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Objectives: To examine the predictors of pediatric ventriculoperitoneal)VP(shunt malfunction in a university hospital. Methods: A retrospective cohort was conducted. Patients under 18 years old who underwent VP shunt revision at least once between 2016 and 2019 were included. Data were stratified based on age, gender, diagnosis, type of valve, valve position, cause of revision, and part revised. Results: A total of 45 patients)64% males and 36% females(were included in this study. Eighty-two revision surgeries were identified. The most common revised part was the entire shunt system. The most Original Article common type of valve which required revision was the low-pressure valve)15.5%(. Since a p-value of less than 0.05 was considered significant, no significant differences among the 4 groups for different points. Conclusions: Younger age at initial VP shunt insertion is associated with a higher rate of shunt malfunction. Valve mechanical failures followed by infections are the most common causes for the first 3 revisions. A prospective multi-center study to confirm the current findings is recommended.

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Section: All the Included Patients Required One Or More Shuntmentioning

confidence: 99%

Section: All the Included Patients Required One Or More Shuntmentioning

confidence: 99%

Section: All the Included Patients Required One Or More Shuntmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Patterns and prognosis of Ventriculoperitoneal shunt malfunction among pediatrics in Saudi Arabia

Altwejri

AlRaddadi

Alsager

et al. 2020

NSJ

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Practical techniques for safely removing long-term implanted ventricular catheters to minimize bleeding

Valença,

Valença

et al. 2024

Childs Nerv Syst

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Retrospective comparison of long-term functionality and revision rate of two different shunt valves in pediatric and adult patients

Busse,

Dubinski,

Gessler

et al. 2023

Acta Neurochir

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Purpose The most frequent therapy of hydrocephalus is implantation of ventriculoperitoneal shunts for diverting cerebrospinal into the peritoneal cavity. We compared two adjustable valves, proGAV and proGAV 2.0, for complications resulting in revision surgery. Methods Four hundred patients undergoing primary shunt implantation between 2014 and 2020 were analyzed for overall revision rate, 1-year revision rate, and revision-free survival observing patient age, sex, etiology of hydrocephalus, implantation site, prior diversion of cerebrospinal fluid, and cause of revision. Results All data were available of all 400 patients (female/male 208/192). Overall, 99 patients underwent revision surgery after primary implantation. proGAV valve was implanted in 283 patients, and proGAV 2.0 valves were implanted in 117 patients. There was no significant difference between the two shunt valves concerning revision rate (p = 0.8069), 1-year revision rate (p = 0.9077), revision-free survival (p = 0.6921), and overall survival (p = 0.3232). Regarding 1-year revision rate, we observed no significant difference between the two shunt valves in pediatric patients (40.7% vs 27.6%; p = 0.2247). Revision operation had to be performed more frequently in pediatric patients (46.6% vs 24.8%; p = 0.0093) with a significant higher number of total revisions with proGAV than proGAV 2.0 (33 of 59 implanted shunts [55.9%] vs. 8 of 29 implanted shunts [27.6%]; p = 0.0110) most likely due to longer follow-up in the proGAV-group. For this reason, we clearly put emphasis on analyzing results regarding 1-year revision rate. Conclusion According to the target variables we analyzed, aside from lifetime revision rate in pediatric patients, there is no significant difference between the two shunt valves.

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Rate and Risk Factors of Early Ventriculoperitoneal Shunt Revision: A Five-Year Retrospective Analysis of a Referral Center

Cited by 17 publications

References 34 publications

Patterns and prognosis of Ventriculoperitoneal shunt malfunction among pediatrics in Saudi Arabia

Patterns and prognosis of Ventriculoperitoneal shunt malfunction among pediatrics in Saudi Arabia

Practical techniques for safely removing long-term implanted ventricular catheters to minimize bleeding

Retrospective comparison of long-term functionality and revision rate of two different shunt valves in pediatric and adult patients

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