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Updated: Apr 14, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ventriculoperitoneal shunt outcomes among infants
Hidehiko Maruyama1, Yusei Nakata, Akane Kanazawa
1Department of Pediatrics, Kochi Health Sciences Center, Kochi 781-8555, Japan.maruyamahidehiko@gmail.com.
Insights
Infants younger than one month undergoing ventriculoperitoneal shunt (VPS) placement face a significantly higher risk of shunt failure. Early intervention is crucial for improving outcomes in pediatric hydrocephalus treatment.
Area of Science:
- Pediatric Neurosurgery
- Medical Device Outcomes
- Hydrocephalus Management
Background:
- Ventriculoperitoneal shunts (VPSs) are a primary treatment for hydrocephalus in infants.
- Shunt failure and infection are significant complications impacting patient outcomes.
- Identifying risk factors for VPS failure is critical for improving treatment efficacy.
Purpose of the Study:
- To analyze the outcomes of VPS placements in infants.
- To determine the specific risk factors associated with shunt failure in this population.
- To identify early indicators for potential VPS complications.
Main Methods:
- Retrospective analysis of 24 infants undergoing initial VPS placement between March 2005 and January 2014.
- Kaplan-Meier curves were used to assess shunt survival rates.
- Multivariate Cox regression analysis was performed to identify independent risk factors for shunt failure.
Main Results:
- The study included 24 infants with a total of 45 shunt procedures.
- Shunt failure occurred at a rate of 0.51 per shunt, with infection rates at 0.13 per shunt.
- Infants younger than one month at the time of VPS placement showed a significantly increased risk of shunt failure (adjusted HR 17.56, p=0.001).
Conclusions:
- Age less than one month at the time of initial VPS placement is a significant risk factor for shunt failure in infants.
- Head circumference above the 90th percentile was also identified as a potential risk factor, though less significant in multivariate analysis.
- These findings underscore the importance of considering patient age in the management of pediatric hydrocephalus and VPS implantation.
Abstract:
Ventriculoperitoneal shunts (VPSs) are used for the treatment of hydrocephalus. Here we analyzed the outcomes of VPS placements in 24 infants to determine the risk factors for shunt failure. The infants had undergone the initial VPS operation in our hospital between March 2005 and December 2013. They were observed until the end of January 2014. We obtained Kaplan-Meier curves and performed a multivariate Cox regression analysis of shunt failure. Of the 24 cases, the median (range) values for gestational age, birth weight, and birth head circumference (HC) were 37 (27-39) wks, 2,736 (686-3,788) g, and 35.3 (23.0-45.3) cm, respectively. The total number of shunt procedures was 45. Shunt failure rates were 0.51/shunt and 0.0053/shunt/year. Shunt infection rates were 0.13/shunt and 0.0014/shunt/year. The Kaplan-Meier analysis revealed an increased risk for shunt failure in infants <1 month old or in the HC >90%tile. The Cox regression analysis yielded hazard ratios (HRs) of 2.93(95% confidence interval (CI), 0.96-10.95, p=0.059) for age <1 month, and 4.46 (95%CI:1.20-28.91, p=0.023) for the HC >90%tile. The multivariate Cox regression analysis showed adjusted HRs of 17.56 (95%CI:2.69-202.8, p=0.001) for age <1 month, and 2.95 (95%CI:0.52-24.84, p=0.228) for the HC >90%tile. Our findings thus revealed that the risk factors for shunt failure in infants include age <1 month at the initial VPS placement.
