Document Detail


Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter.
MedLine Citation:
PMID:  9347975     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors describe a relationship between the presence of distal shunt catheter side-wall slits and distal catheter obstruction in a single-surgeon series of ventriculoperitoneal (VP) shunt revisions. Between 1985 and 1996, 168 operations for VP shunt revision were performed by the senior author (J.W.C.) in 71 patients. Indications for shunt revision included obstruction in 140 operations; overdrainage or underdrainage requiring a change of valve in 17 operations; inadequate length of distal shunt tubing resulting in the distal end no longer reaching the peritoneum in five operations; the ventricular catheter in the wrong ventricle or space, requiring repositioning in five operations; and a disconnected or broken shunt in one operation. Of the 140 instances of shunt obstruction, the blockage occurred at the ventricular end in 108 instances (77.1%), the peritoneal end in 17 (12.1%), the ventricular and the peritoneal end in 14 (10%), and in the valve mechanism (not including distal slit valves) in one (0.8%). Thus, the peritoneal end was obstructed in 31 (22.1%) of 140 cases of shunt malfunction. In every case in which the peritoneal end was obstructed, some form of distal slit was found: either a distal slit valve in an otherwise closed catheter or slits in the side of an open catheter. No instances were found of distal peritoneal catheter obstruction when the peritoneal catheter was a simple open-ended tube with no accompanying side slits (0 of 55). It is concluded that side slits in the distal peritoneal catheters of VP shunts are associated with a greater incidence of distal shunt obstruction.
Authors:
J W Cozzens; J P Chandler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  87     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1997-11-05     Completed Date:  1997-11-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  682-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Neurosurgery, Northwestern University Medical School, Evanston Hospital, Illinois 60201, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Catheters, Indwelling
Child
Child, Preschool
Equipment Failure
Humans
Infant
Life Tables
Proportional Hazards Models
Reoperation
Risk
Time Factors
Ventriculoperitoneal Shunt*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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