Document Detail


Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used.
MedLine Citation:
PMID:  12854744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The goal of this study was to evaluate the long-term results of a flow-regulating shunt (Orbis Sigma Valve [OSV] II Smart Valve System; Integra NeuroSciences, Sophia Antipolis, France) in the treatment of hydrocephalus, whether it was a first insertion procedure or surgical revision of another type of shunt, in everyday clinical practice in a multicenter prospective study. METHODS: Patients of any age who had hydrocephalus underwent implantation of an OSV II system. The primary end point of the study was defined as any shunt-related surgery. The secondary end point was a mechanical complication (shunt obstruction, overdrainage, catheter misplacement, migration, or disconnection) or infection. The overall 5-year shunt survival rates and survival as it applied to different patient subgroups were assessed. Five hundred fifty-seven patients (48% of whom were adults and 52% of whom were children) were selected for OSV II shunt implantation; 196 patients reached the primary end point. Shunt obstruction occurred in 75 patients (13.5%), overdrainage in 10 patients (1.8%), and infection in 46 patients (8.2%). The probability of having experienced a shunt failure-free interval at 1 year was 71% and at 2 years it was 67%; thereafter the probability remained quite stable in following years (62% at the 5-year follow-up examination). No difference in shunt survival was observed between the overall pediatric (< or = 16 years of age) and adult populations. In the pediatric age group, however, there was a significantly lower rate of shunt survival in children younger than 6 months of age (55% at the 5-year follow-up examination). CONCLUSIONS: In this prospective study the authors demonstrate the effectiveness of flow regulation in the treatment of hydrocephalus both in children and in adults. Flow-regulating shunts limit the incidence of overdrainage and shunt-related complications. The overall 5-year shunt survival rate (62%) compares favorably with rates cited in other recently published series.
Authors:
Patrick W Hanlo; Giuseppe Cinalli; W Peter Vandertop; Joop A J Faber; Lars Bøgeskov; Svend E Børgesen; Jürgen Boschert; Paul Chumas; Hans Eder; Ian K Pople; Willy Serlo; Eckehard Vitzthum
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  99     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-11     Completed Date:  2003-08-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  52-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Utrecht University Medical Center, Wilhelmina's Children's Hospital, Utrecht, The Netherlands. p.hanlo-2@wkz.azu.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anthropometry
Cerebral Ventricles / anatomy & histology,  surgery
Cerebrospinal Fluid Shunts* / instrumentation,  mortality
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Hydrocephalus / surgery*
Infant
Infant, Newborn
Male
Middle Aged
Prospective Studies
Questionnaires
Survival Rate

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


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