Related Experiment Video
Updated: May 12, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ventriculo-Abdominal Subcutaneous Tunneled External Drainage as a Transition Therapy to Reduce Shunt Failure Rate in
Long Yao1, Liyi Shen1, Xiaolei Liu1
1Department of Neurosurgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Objective:
Assess the clinical efficacy of Ventriculo-Abdominal Subcutaneous Tunneled External Drainage (VASTED) as a transition treatment before ventriculoperitoneal shunt (VPS) in the management of postinfectious hydrocephalus (PIH).
Methods:
This study enrolled 384 patients who developed PIH after craniotomy. Following external ventricular drainage and combined intravenous antibiotic therapy, patients underwent VASTED as a transitional treatment measure before definitive VPS placement when they achieved 3 consecutive negative cerebrospinal fluid bacterial cultures within 2 weeks and no pathogen detection by metagenomic next-generation sequencing. The primary endpoint of the study was the shunt failure rate after 1 year of follow-up, with infection and catheter blockage as the evaluation criteria.
Results:
A total of 378 cases underwent VPS surgery, with 6 cases refusing or abandoning treatment. During a 1-year follow-up period, 9 shunt failures occurred (2.38%, 95% confidence interval: 0.43-3.05). Among these, 5 failures were infection-related (1.3%) and 4 were due to pure mechanical obstruction (1.1%). The shortest duration of VASTED was 14 days, while the longest was 387 days, with a median drainage time of 69 days (95% confidence interval: 28-112 days).
Conclusions:
In patients with PIH, implementing VASTED as a transitional surgical treatment approach is closely associated with an extremely low 1-year failure rate of VPS. This transitional strategy can significantly reduce the high failure rate following VPS.