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Evaluating Shunt Survival Following Ventriculoperitoneal Shunting with and without Stereotactic Navigation in Previously Shunt-Naïve Patients.

Publication ,  Journal Article
Jin, MC; Wu, A; Azad, TD; Feng, A; Prolo, LM; Veeravagu, A; Grant, GA; Ratliff, J; Li, G
Published in: World Neurosurg
April 2020

BACKGROUND: Ventriculoperitoneal shunts are used to alleviate elevated intracranial pressure due to either hydrocephalus or idiopathic intracranial hypertension; however, shunt failure is a significant neurosurgical problem. Despite increases in intraoperative stereotactic navigation usage over the past decade, its effect on shunt survival remains unclear. METHODS: Shunt-naïve pediatric and adult patients receiving ventriculoperitoneal shunting between 2007 and 2015 were identified in a national administrative database. Multivariable logistic and Cox regressions were used to evaluate factors affecting stereotaxy usage and shunt survival. Matched cohorts were generated by propensity score balancing. RESULTS: Of 9677 patients identified, 932 received image-guided shunt placement. Total shunt failure rate was not associated with stereotaxy use (20.3% with stereotaxy vs. 19.4% without, P = 0.4602). In the matched setting, shunt survival was not extended by use of image guidance during placement (hazard ratio = 1.134, 95% confidence interval 0.923-1.393). Late shunt failures (defined as failures occurring at least 30 days after shunt placement) caused by infection occurred more frequently in the stereotaxy cohort (hazard ratio = 2.207, 95% confidence interval 1.115-4.366), whereas late shunt failures attributable to mechanical shunt failure were more common in the nonstereotaxy cohort (hazard ratio = 1.406, 95% confidence interval 1.002-1.973). CONCLUSIONS: Our findings suggest stereotaxy use during ventriculoperitoneal shunt placement does not affect shunt survival. Late shunt failures caused by infection occurred more frequently in the stereotaxy cohort, whereas late failures caused by mechanical shunt malfunction were more commonly encountered in the nonstereotaxy cohort.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

April 2020

Volume

136

Start / End Page

e671 / e682

Location

United States

Related Subject Headings

  • Ventriculoperitoneal Shunt
  • Prospective Studies
  • Neuronavigation
  • Middle Aged
  • Male
  • Intracranial Hypertension
  • Hydrocephalus
  • Humans
  • Female
  • Equipment Failure
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jin, M. C., Wu, A., Azad, T. D., Feng, A., Prolo, L. M., Veeravagu, A., … Li, G. (2020). Evaluating Shunt Survival Following Ventriculoperitoneal Shunting with and without Stereotactic Navigation in Previously Shunt-Naïve Patients. World Neurosurg, 136, e671–e682. https://doi.org/10.1016/j.wneu.2020.01.138
Jin, Michael C., Adela Wu, Tej D. Azad, Austin Feng, Laura M. Prolo, Anand Veeravagu, Gerald A. Grant, John Ratliff, and Gordon Li. “Evaluating Shunt Survival Following Ventriculoperitoneal Shunting with and without Stereotactic Navigation in Previously Shunt-Naïve Patients.World Neurosurg 136 (April 2020): e671–82. https://doi.org/10.1016/j.wneu.2020.01.138.
Jin MC, Wu A, Azad TD, Feng A, Prolo LM, Veeravagu A, et al. Evaluating Shunt Survival Following Ventriculoperitoneal Shunting with and without Stereotactic Navigation in Previously Shunt-Naïve Patients. World Neurosurg. 2020 Apr;136:e671–82.
Jin, Michael C., et al. “Evaluating Shunt Survival Following Ventriculoperitoneal Shunting with and without Stereotactic Navigation in Previously Shunt-Naïve Patients.World Neurosurg, vol. 136, Apr. 2020, pp. e671–82. Pubmed, doi:10.1016/j.wneu.2020.01.138.
Jin MC, Wu A, Azad TD, Feng A, Prolo LM, Veeravagu A, Grant GA, Ratliff J, Li G. Evaluating Shunt Survival Following Ventriculoperitoneal Shunting with and without Stereotactic Navigation in Previously Shunt-Naïve Patients. World Neurosurg. 2020 Apr;136:e671–e682.

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

April 2020

Volume

136

Start / End Page

e671 / e682

Location

United States

Related Subject Headings

  • Ventriculoperitoneal Shunt
  • Prospective Studies
  • Neuronavigation
  • Middle Aged
  • Male
  • Intracranial Hypertension
  • Hydrocephalus
  • Humans
  • Female
  • Equipment Failure