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  • Title: Ventriculosinus shunt as a reliable option in the treatment of failed ventriculoperitoneal shunt: report of 19 cases and review of the literature.
    Author: Li X, Zheng J.
    Journal: Ann Palliat Med; 2021 Jul; 10(7):7627-7633. PubMed ID: 34353050.
    Abstract:
    BACKGROUND: The authors of this study aim to summarize their experience with lateral ventriculosinus shunt in the treatment of hydrocephalus patients and assess its clinical value. METHODS: Ventriculoperitoneal shunt was performed but failed due to obstruction and infection of the shunt. Lateral ventriculosinus shunt was inserted in 19 hydrocephalus patients by a Medtronic programmable shunt valve. All 19 patients suffered from either an obstruction or infection after ventriculoperitoneal shunting, while 11 cases had a peritoneal obstruction, 8 cases had an intracranial infection, and 1 case had an intra-abdominal infection. Among the 19 cases, there were 2 cases with obstructive hydrocephalus and 17 cases with communicating hydrocephalus. RESULTS: All clinical symptoms of 9 patients disappeared completely, while for 8 patients, noticeable improvement was accomplished, and only 2 patients showed no improvement. All 19 cases were followed up for 6 to 60 months. During the follow-up period, in 17 patients the shunt remained effective, while 2 cases underwent removal of the shunt due to low preoperative intracranial pressure and no significant changes in postoperative symptoms and ventricular size. During follow-up there was no thrombosis in the sagittal sinus, and no infection, over drainage, intracranial hemorrhage, or subdural effusion occurred. CONCLUSIONS: We demonstrate that lateral ventriculosinus shunt is a reliable option for failed ventriculoperitoneal shunt hydrocephalus patients. Nevertheless, the effectiveness and possible complications of this method need further confirmation by observation in a study with a larger cohort.
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