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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
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Ventriculoperitoneal Shunt Complications in the European Idiopathic Normal Pressure Hydrocephalus Multicenter Study
Alberto Feletti1, Domenico d'Avella2, Carsten Wikkelsø3
1Department of Neurosciences, Unit of Neurosurgery, NOCSAE Modena Hospital, Modena, Italy.
Operative Neurosurgery (Hagerstown, Md.)
|September 1, 2018
Summary
Ventriculoperitoneal shunts for idiopathic normal pressure hydrocephalus have a low complication rate, with most issues managed non-surgically within six months. Advances in valve technology and careful follow-up improve outcomes for shunt surgery patients.
Area of Science:
- Neurosurgery
- Neurology
- Medical Device Technology
Background:
- Ventriculoperitoneal (VP) shunt placement is standard for idiopathic normal pressure hydrocephalus (iNPH).
- Limited data exists on VP-shunt complications specifically in iNPH patients.
- A comprehensive analysis of VP-shunt complications in iNPH is needed.
Purpose of the Study:
- To analyze and report the incidence of VP-shunt complications within the first year post-surgery.
- To investigate complications in iNPH patients enrolled in the European multicenter (EU-iNPH) study.
- To assess symptomatic overdrainage, underdrainage, infections, and shunt malfunctions.
Main Methods:
- Prospective enrollment of 142 iNPH patients across 13 European institutions.
- All patients received programmable VP-shunts with 115 completing 12-month follow-up.
- Data collection included symptomatic drainage issues, infections, malposition, subdural collections, and revision surgeries at 1, 3, and 12 months.
Main Results:
- Underdrainage symptoms affected 26% of patients; overdrainage affected 9%.
- Shunt malfunctions occurred in 7% (malposition), with only one infection (0.9%).
- 15% of patients required 19 revision surgeries, with subdural hematoma (6%) and hygroma (9%) also noted.
Conclusions:
- Modern valve technology, precise opening pressure settings, and diligent follow-up minimize VP-shunt complications.
- Most complications in iNPH patients are manageable non-surgically within 3-6 months.
- Improved management strategies enhance safety and efficacy of VP-shunts for iNPH.
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