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Updated: Jun 3, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Shunt failure due to intracranial migration of BioGlide ventricular catheters
Hsin-Hung Chen1, Jay Riva-Cambrin, Douglas L Brockmeyer
1Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan, Republic of China.
Object:
In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US.
Methods:
After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified.
Results:
Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnection was 2.7 years (range 4 days-5.8 years). Computed tomography slices in the plane of the catheter helped visualize disconnections. Retrieval was difficult, and in 5 patients the disconnected catheter was not removable. Three catheters were completely within the ventricle. At presentation, 4 children suffered from severe neurological deficits, including one who died as a result of the shunt malfunction.
Conclusions:
BioGlide snap-design ventricular catheters are prone to disconnection. Continued vigilance and specific imaging are important. Catheter removal after disconnection may be difficult. Elective removal prior to disconnection in asymptomatic children has not been performed.
Insights
Bio-Glide Snap Shunt catheters can disconnect, leading to serious complications and recall. Early detection through specific imaging is crucial for managing this ventriculoperitoneal shunt failure.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Medical Device Safety
Background:
- Ventriculoperitoneal shunts are critical for treating hydrocephalus.
- The Bio-Glide Snap Shunt ventricular catheter was introduced with a novel snap-design.
- A specific failure mode, catheter disconnection, was identified.
Purpose of the Study:
- To investigate a novel failure mode of Bio-Glide Snap Shunt ventricular catheters.
- To report on the incidence, clinical presentation, and management of catheter disconnections.
- To inform clinical practice and patient safety regarding this device.
Main Methods:
- Retrospective review of patient cohort implanted with Bio-Glide Snap Shunt catheters.
- Identification of index cases and subsequent case finding.
- Notification of the Food and Drug Administration (FDA) leading to product recall.
- Patient communication via letters, a dedicated call center, and an informational website video.
- Review of medical records and imaging (CT scans) for identified cases.
Main Results:
- Twenty-three cases of catheter disconnection were identified in 466 implanted catheters.
- Mean time to disconnection was 2.7 years, with a wide range.
- Computed tomography (CT) imaging in the plane of the catheter aided visualization.
- Catheter retrieval was challenging; in 5 cases, removal was not possible.
- Four children experienced severe neurological deficits, and one patient died due to shunt malfunction.
Conclusions:
- Bio-Glide snap-design ventricular catheters exhibit a propensity for disconnection.
- Vigilance and specialized imaging techniques are essential for diagnosing disconnections.
- Management of disconnected catheters can be complex, with potential difficulties in removal.
- The efficacy of elective prophylactic removal in asymptomatic patients remains unstudied.