Related Experiment Video

Updated: Jan 30, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

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Shunted Hydrocephalus: Who Has More Chances to Get Rid of the Shunt?

Mino Zucchelli1, Francesca Nicolini1, Francesco Toni2

  • 1IRCCS Istituto delle Scienze Neurologiche di Bologna, Pediatric Neurosurgery, Bologna, Italy.

World Neurosurgery
|January 27, 2019
PubMed

Insights

Secondary endoscopic third ventriculostomy (ETV) offers a successful alternative to shunt removal in hydrocephalus patients with shunt malfunction. Patient age, prior shunt revisions, and ETV success score predict successful outcomes.

Area of Science:

  • Neurosurgery
  • Neurology
  • Pediatric Neurosurgery

Background:

  • Cerebrospinal fluid (CSF) shunts significantly impact hydrocephalus patient outcomes.
  • Long-standing shunts present numerous complications, necessitating shunt removal attempts.
  • Secondary endoscopic third ventriculostomy (ETV) is explored for shunt removal in malfunction cases.

Purpose of the Study:

  • To evaluate the efficacy of secondary ETV for shunt removal in hydrocephalus patients.
  • To identify patient factors predicting successful shunt independence after secondary ETV.

Main Methods:

  • A cohort of 47 patients over 6 months old with ventriculoperitoneal shunt malfunction underwent secondary ETV between 2006-2015.
  • Shunt removal or ligation was performed concurrently with ETV.
  • Patients were assessed for shunt independence, normalized intracranial pressure, and symptom resolution.

Main Results:

  • The overall success rate for secondary ETV was 74%, achieving shunt independence.
  • Long shunt duration (up to 30 years) did not preclude success.
  • Factors predicting ETV failure included a higher number of previous shunt revisions (P=0.026) and younger age (P=0.017).
  • A higher ETV success score correlated with successful secondary ETV outcomes (P=0.014).

Conclusions:

  • Secondary ETV is a viable option for shunt removal in many hydrocephalus patients, even after prolonged shunting.
  • Key predictors of success include patient age, prior shunt revision history, and the ETV success score.
  • These factors aid in selecting optimal candidates for secondary ETV to achieve shunt independence.
Abstract

Keywords:
HydrocephalusSecondary endoscopic third ventriculostomyShunt malfunction

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