Improved ventriculoatrial shunt for cerebrospinal fluid diversion after multiple ventriculoperitoneal shunt failures

• Published in: Surgical neurology 2009-08, Vol.72, p.S29-S33
• Main Authors: Zhang, Jiqing, MD, Qu, Chuncheng, MD, Wang, Zhigang, MD, Wang, Chengwei, PhD, Ding, Xuan, MD, Pan, Shun, MD, Ji, Yong, PhD
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cerebrospinal Fluid Shunts - methods; Equipment Failure; Feasibility Studies; Female; Heart Atria - surgery; Humans; Hydrocephalus; Hydrocephalus - diagnostic imaging; Hydrocephalus - surgery; Male; Medical sciences; Middle Aged; Neurology; Neurosurgery; Percutaneous insertion; Retrospective Studies; Shunt failure; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Third Ventricle - surgery; Tomography, X-Ray Computed; Treatment Outcome; Ventriculoatrial shunt; Ventriculoperitoneal Shunt
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/j.surneu.2008.03.040

Abstract Background Hydrocephalus provides challenging management decisions because of multiple VP shunt failures. Ventriculoperitoneal shunt failure requires urgent management and surgical intervention. We reviewed the outcome of 6 patients who received a conversion from VP to IVA shunt with 8F percutaneous catheter introducer set after previous multiple VP failures to evaluate its efficacy. Methods We conducted a retrospective review of 6 patients with multiple previous VP shunt failures treated with an IVA shunt with interventional device 8F percutaneous catheter introducer set at the Second Hospital of Shandong University between May 2005 and July 2007. In this study, clinical manifestation and feasibility of this kind of improved method were analyzed before and after operation. Results The results of CSF diversion after IVA shunt are generally good in terms of improved clinical improvement and reduced ventricular size as shown in the CT scans. All 6 patients successfully underwent conversion from VP to IVA shunt and obtained a functioning VA shunt; no shunt malfunctions occurred during the follow-up period of 3 to 20 months. Conclusion Although small, this study indicates that it is feasible to consider converting from VP to IVA shunt systems in patients with multiple previous VP shunt failures with 8F percutaneous catheter introducer set. This method is a new technique combined with interventional device in the treatment of hydrocephalus, which can relieve hydrocephalic patients of their sufferings.