Programmable Shunt Valves for Pediatric Hydrocephalus: 22-Year Experience from a Singapore Children’s Hospital
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Demographics
2.2. Incidence of Opening Pressure Adjustments in PSV
2.3. Statistical Methods
3. Results
3.1. Overview of Study Population and its Demographics
3.2. Types of PSV Encountered and Shunt Failure Rate
3.3. Analysis of Frequency of PSV Adjustments
4. Discussion
4.1. Is There a Therapeutic Role for PSV in Pediatric Hydrocephalus?
4.2. Quantifying Adjustments in PSV—Has Our Use Been Appropriate?
4.3. Limitations of the PSV
4.4. Study Limitations and Future Directions
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Medtronic PS Medical® Strata® | Codman Certas Plus | MIETHKE proGAV® 2.0 | Codman Hakim | Sophysa Polaris | |
---|---|---|---|---|---|
Pressure range (mmH2O) | 15–220 | 25–400 | 0–200 | 30–200 | 30–200 |
Number of settings | 5 | 8 | 20 | 18 | 5 |
‘Virtual off’ function | No | Yes | No | No | No |
MRI-safe | Yes | Yes | Yes | Yes | Yes |
MRI-resistant | No | Yes, up to 3 Tesla | Yes, up to 3 Tesla | No | No |
MRI artefacts | Yes, worse at higher settings | Yes, worse at higher settings | Yes, worse at lower settings | Yes, based on in vitro findings | Yes, worse at higher settings |
Verification and adjustment of settings | Portable, handheld adjuster tool | Portable, handheld adjuster tool | Portable, handheld adjuster tool | Requires X-ray verification | Portable, handheld adjuster tool |
Availability in Singapore | Yes | Yes | Yes | Yes | No |
Availability in small sizes | Yes | Yes, but not available in Singapore | Yes | Microvalve shunt available by manufacturer, but not available in Singapore | No |
Before 2016 | From 2016 Onwards | p-Value | |
---|---|---|---|
Mean number of adjustments per PSV | 0.8 SD ± 0.9 | 2.1 SD ± 1.7 | p = 0.031 |
Comparison between Subgroups of PSV Patients | Mean Number of Adjustments per PSV | p-Value |
Revision shunts versus index shunts | 2.2; SD ± 1.9 1.7; SD ± 1.6 | p = 0.488 |
Tumor-related versus other etiologies | 2.3; SD ± 1.6 | p = 0.107 |
1.1; SD ± 1.5 | ||
Previous CSF over-drainage shunts versus all other shunt revisions | 3.7; SD ± 2.1 | p = 0.231 |
1.7; SD ± 1.7 |
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Tey, M.L.; Ng, L.P.; Low, D.C.Y.; Seow, W.T.; Low, S.Y.Y. Programmable Shunt Valves for Pediatric Hydrocephalus: 22-Year Experience from a Singapore Children’s Hospital. Brain Sci. 2021, 11, 1548. https://0-doi-org.brum.beds.ac.uk/10.3390/brainsci11111548
Tey ML, Ng LP, Low DCY, Seow WT, Low SYY. Programmable Shunt Valves for Pediatric Hydrocephalus: 22-Year Experience from a Singapore Children’s Hospital. Brain Sciences. 2021; 11(11):1548. https://0-doi-org.brum.beds.ac.uk/10.3390/brainsci11111548
Chicago/Turabian StyleTey, Min Li, Lee Ping Ng, David C. Y. Low, Wan Tew Seow, and Sharon Y. Y. Low. 2021. "Programmable Shunt Valves for Pediatric Hydrocephalus: 22-Year Experience from a Singapore Children’s Hospital" Brain Sciences 11, no. 11: 1548. https://0-doi-org.brum.beds.ac.uk/10.3390/brainsci11111548