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Updated: May 21, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ventriculoperitoneal shunt failure: an institutional review of 2-year survival rates
Chevis N Shannon1, Leslie Acakpo-Satchivi, Russell S Kirby
1Division of Neurosurgery, Section of Pediatric Neurosurgery, Children's Hospital of Alabama, University of Alabama, 400 Ambulatory Care Center, 1600 7th Ave South, Birmingham, AL 35233, USA. chevis.shannon@childrensal.org
Insights
Ventriculoperitoneal (VP) shunt failure in children with hydrocephalus is common. Age and weight at initial VP shunt insertion predict failure in non-intraventricular hemorrhage (IVH) patients, highlighting the need for further research.
Area of Science:
- Pediatric Neurosurgery
- Hydrocephalus Research
- Medical Device Performance
Background:
- Long-term survival of shunts in pediatric hydrocephalus patients remains a challenge.
- Etiology, birth weight, and gestational age are potential risk factors for shunt failure, but vary across populations.
- Identifying specific factors for initial ventriculoperitoneal (VP) shunt failure is crucial for improving outcomes.
Purpose of the Study:
- To identify social, clinical, and neonatal factors associated with initial VP shunt failure.
- To analyze failure predictors in both intraventricular hemorrhage (IVH) and non-IVH pediatric hydrocephalus cohorts.
- To compare risk factors between different etiological groups.
Main Methods:
- Retrospective review of pediatric hydrocephalus patients treated between 2000-2005.
- Survival analysis to determine factors associated with time to shunt failure.
- Separate analyses for IVH and non-IVH patient cohorts.
Main Results:
- Age and weight at initial VP shunt insertion were significant predictors of shunt failure in the non-IVH group (p < .05).
- In the non-IVH cohort, 108 of 238 patients experienced shunt failure within 2 years, with 50 occurring within 3 months.
- In the IVH cohort, 56 of 100 patients failed within 2 years, with 36 occurring within 3 months.
- Age at initial shunt placement was associated with time to shunt failure when controlling for failure type (p = .0004).
Conclusions:
- Findings confirm previous studies regarding shunt failure in the IVH population.
- Age at initial shunt placement is a critical factor influencing VP shunt survival.
- Further prospective studies and standardized clinical decision-making are recommended to optimize shunting strategies.
Purpose:
Prior research has examined predictors of shunt failure in children with hydrocephalus and concluded that the majority of shunts do not survive long-term. However, risk factors such as etiology, birth weight, and gestational age may vary across institutions and populations. We sought to identify the social, clinical, and neonatal factors associated with initial ventriculoperitoneal (VP) shunt failure in the intraventricular hemorrhage (IVH) patient population and the patient population with an etiology other than IVH (non-IVH).
Methods:
A retrospective review of patients, born during 2000-2005 diagnosed and treated for hydrocephalus at Children's of Alabama was conducted. Survival analysis identified factors associated with time to shunt failure.
Results:
Analyses were done separately for the IVH and non-IVH cohorts. Age and weight at initial VP shunt insertion were found to be associated with shunt failure in the non-IVH group (p < .05). Of the 238 patients in the non-IVH cohort, 108 failed within 2 years of their initial insertion. Fifty of those shunt failures occurred within 3 months of initial shunt placement. In the IVH cohort, 56 out of 100 failed within 2 years; 36 of those failed within 3 months post initial shunt insertion. When controlling for type of shunt failure, age at initial shunt placement was associated with time to shunt failure (p = .0004).
Conclusion:
This study confirms previously published studies on the IVH population. A prospective cohort study and standardized clinical decision making are necessary to further assess the impact that shunting has on this patient population.
