Background And Objectives: The most common treatment for hydrocephalus is ventriculoperitoneal (VP) shunting, which is problematic as shunts are prone to failure. Shunt disconnections account for a minority (8%-15%) of VP shunt failures but could be reduced through better shunt design. A better understanding of the mechanical properties of VP shunts would help explain why shunt disconnections occur. The objective of this study was to determine if the tensile properties of VP shunts differ by design.
Methods: Linear tensile testing was conducted on 5 different valve designs (Codman Certas Plus Programmable Valve, Medtronic Delta, Integra Orbis Sigma Valve II, Medtronic PS Medical, Medtronic Strata Adjustable Valve) at both the proximal and distal ends to determine the maximum load which could be applied to different shunt designs. Each valve was progressively subjected to increasing force until the catheter disconnected from the valve, the catheter fractured, or our maximum testing limits were reached.
Results: Catheters disconnected or fractured during testing with all valves. The maximum load resisted during tensile testing for similar locations in all valve designs were found to be statistically similar to one another. Only the PS Medical and Orbis Sigma II valves showed an increased maximum load at the distal end compared with the proximal end within the same device.
Conclusion: No single valve design was superior at preventing disconnections in VP shunts. Shunt disconnections remain a concerning problem as VP shunts are the gold standard for combating hydrocephalus.
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http://dx.doi.org/10.1227/ons.0000000000001262 | DOI Listing |
Childs Nerv Syst
January 2025
Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Children's of Alabama, 1600 7th Avenue South, Lowder 400, Birmingham, AL, 35233, USA.
Purpose: We hypothesize that distal shunt catheters fully impregnated with barium are more prone to failure compared to distal catheters with only a barium stripe. We sought to evaluate this distinction using a matched case-control study.
Methods: Patient records over an 8-year period were queried for distal shunt revisions for fracture or disconnection (cases).
Surg Neurol Int
October 2024
Neurosurgery Division, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
BMJ Case Rep
November 2024
Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
A male in his 20s was referred to the neurosurgical service with headaches, vomiting and personality changes. He had a previous history of bilateral ventriculoperitoneal (VP) shunts and bitemporal decompressive surgery for neonatal intraventricular haemorrhage. There were appearances of slit-ventricles on his CT head scan typically associated with adequate cerebrospinal fluid drainage and normal intracranial pressure (ICP), which ordinarily will have limited further investigation.
View Article and Find Full Text PDFJ Neurosurg Pediatr
January 2025
2Pediatric Neurology, Helsinki University Hospital, Helsinki, Finland.
Front Neurosci
October 2024
Department of Neurosurgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
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