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Updated: Nov 6, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Reconversion to ventriculoperitoneal shunt following ventriculoatrial shunt malfunction in children
Shota Yamashita1, Tomomi Kimiwada2, Toshiaki Hayashi1
1Department of Neurosurgery, Miyagi Children's Hospital, Sendai, Japan.
Insights
Ventriculoatrial shunt (VAS) in pediatric hydrocephalus patients requires frequent revisions, especially in younger children. Reconversion to a ventriculoperitoneal shunt (VPS) offers a viable alternative with improved long-term outcomes.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Medical Device Engineering
Background:
- Hydrocephalus is a common neurological condition in children.
- Ventriculoatrial shunt (VAS) is a treatment option for hydrocephalus.
- Distal catheter malformation is a known complication of shunts.
Purpose of the Study:
- To evaluate the long-term effectiveness of ventriculoatrial shunt (VAS) in pediatric hydrocephalus.
- To analyze atrial catheter performance and revision strategies for distal catheter issues.
- To assess outcomes of VAS malformation revisions at our institution.
Main Methods:
- Retrospective analysis of 28 pediatric patients (<10 years) treated with VAS.
- Minimum 5-year follow-up period.
- Analysis of atrial tube revision procedures and shunt survival.
Main Results:
- 42 atrial tube revisions in 28 patients.
- Median atrial tube survival: 2.32 years (obstruction).
- Shorter survival in younger/shorter children (p<0.0001).
- 78.6% reconverted to VPS due to malfunction.
Conclusions:
- VAS is an alternative to VPS but needs frequent revisions, particularly in young children.
- Reconversion to VPS after VAS malfunction is a reasonable option.
- VPS reconversion is associated with longer shunt survival despite prior challenges.
Purpose:
To analyze the long-term efficacy of the ventriculoatrial shunt (VAS) in pediatric patients with hydrocephalus, focusing on the atrial catheter and suitable revision procedures of the distal catheter following VAS malformation performed at our institution.
Methods:
The authors retrospectively analyzed data of 28 pediatric patients under the age of 10 years who were treated with VAS for hydrocephalus and who had a follow-up period of at least 5 years.
Results:
A total of 42 atrial tube revision procedures were performed in 28 patients during the study period. The median atrial tube survival time due to atrial tube obstruction was 2.32 years (n = 31, range: 0.4-8.08 years). Atrial tube survival time was shorter in younger children (p < 0.0001) and in children who were shorter in height (p = 0.0001). As a revision procedure following atrial tube malfunction, 22 (78.6%) out of the 28 patients who had an inserted VAS had the VAS reconversion into a VPS at the last follow-up.
Conclusions:
VAS can be a useful alternative to VPS, but it requires frequent atrial tube revisions, especially in younger children. Reconversion to VPS after VAS malfunction is a reasonable option and is associated with longer shunt survival time despite its previously observed difficulties.
