{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:56:30Z","timestamp":1780570590656,"version":"3.54.1"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Hydrocephalus with a blocked ventriculoperitoneal (VP) shunt is a life-threatening condition. Emergency endoscopic third ventriculostomy (ETV) is a potential treatment option. The aim of the study was to identify independent risk factors associated with failure of ETV in treating patients with blocked shunts.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors retrospectively reviewed data from consecutive patients admitted for blocked shunt treated by ETV during the study period from 2000 to 2016. Univariate and multivariate analyses were performed to identify independent factors associated with failed ETV for blocked shunts, such as age, sex, history of CNS infection, number of previous shunt revisions, operations performed as an emergency or elective, number of specialists, and other factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In total, 121 patients underwent ETV during the study period. Of these, 31 patients (25.6%) had ETV for treatment of a blocked shunt. In 25 (80.6%) of 31 ETV was performed as an emergency procedure. There was no significant difference in the success rate of ETV depending on whether it was performed as an emergency procedure (64% [16\/25]) or an elective procedure (66.7% [4\/6]; OR 0.062, 95% CI 0.001\u20132.708; p = 0.149). Univariate and multivariate analyses identified that history of a CNS infection was an independent risk factor for failure of ETV in treating patients with a blocked shunt (OR 0.030, 95% CI 0.001\u20130.888; p = 0.043).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Emergency ETV had a comparable success rate as elective ETV. A history of CNS infection is an independent predictor of ETV failure in treating patients with blocked shunts.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.6.jns1865","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:13:27Z","timestamp":1551226407000},"page":"1004-1010","source":"Crossref","is-referenced-by-count":7,"title":["Emergency endoscopic third ventriculostomy for blocked shunts? Univariate and multivariate analysis of independent predictors for failure"],"prefix":"10.3171","volume":"131","author":[{"given":"David Y. C.","family":"Chan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson C. O.","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson W. S.","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin K. F.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai F.","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick C. P.","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedict B. T.","family":"Taw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny K. S.","family":"Pu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto K. K.","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W. M.","family":"Lui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s00381-008-0779-1","article-title":"Endoscopic third ventriculostomy for malfunction in previously shunted infants","volume":"25","author":"Bilginer B","year":"2009","unstructured":"Bilginer B, Oguz KK, Akalan N: Endoscopic third ventriculostomy for malfunction in previously shunted infants. Childs Nerv Syst 25:683\u2013688, 20091908260810.1007\/s00381-008-0779-1"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.3171\/jns.2003.98.5.1032","article-title":"Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review","volume":"98","author":"Boschert J","year":"2003","unstructured":"Boschert J, Hellwig D, Krauss JK: Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review. J Neurosurg 98:1032\u20131039, 200310.3171\/jns.2003.98.5.103212744363"},{"key":"b3","series-title":"Surg Pract","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/1744-1633.12316","article-title":"Extraventricular intracisternal obstructive hydrocephalus? A differential diagnosis of \u201ccommunicating hydrocephalus\u201d after a successful endoscopic third ventriculostomy","volume":"22","author":"Chan DYC","year":"2018","unstructured":"Chan DYC, Zhu CXL, Chan DTM, Poon WS: Extraventricular intracisternal obstructive hydrocephalus? A differential diagnosis of \u201ccommunicating hydrocephalus\u201d after a successful endoscopic third ventriculostomy. Surg Pract 22:145\u2013147, 201810.1111\/1744-1633.12316"},{"key":"b4","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1016\/j.wneu.2015.01.058","article-title":"Third ventriculocisternostomy for shunt failure","volume":"83","author":"Chhun V","year":"2015","unstructured":"Chhun V, Sacko O, Boetto S, Roux FE: Third ventriculocisternostomy for shunt failure. World Neurosurg 83:970\u2013975, 20152577261010.1016\/j.wneu.2015.01.058"},{"key":"b5","series-title":"Neurosurgery","first-page":"1323","article-title":"The role of endoscopic third ventriculostomy in the management of shunt malfunction","volume":"43","author":"Cinalli G","year":"1998","unstructured":"Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C: The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 43:1323\u20131329, 19989848845"},{"key":"b6","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1227\/01.NEU.0000255420.78431.E7","article-title":"Endoscopic third ventriculostomy in pediatric patients: the Canadian experience","volume":"60","author":"Drake JM","year":"2007","unstructured":"Drake JM: Endoscopic third ventriculostomy in pediatric patients: the Canadian experience. Neurosurgery 60:881\u2013886, 20071741353010.1227\/01.NEU.0000255420.78431.E7"},{"key":"b7","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1097\/00006123-200005000-00015","article-title":"Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus","volume":"46","author":"Fukuhara T","year":"2000","unstructured":"Fukuhara T, Vorster SJ, Luciano MG: Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery 46:1100\u20131111, 200010.1097\/00006123-200005000-0001510807242"},{"key":"b8","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s00381-007-0303-z","article-title":"Paradigm shift in hydrocephalus research in legacy of Dandy\u2019s pioneering work: rationale for third ventriculostomy in communicating hydrocephalus","volume":"23","author":"Greitz D","year":"2007","unstructured":"Greitz D: Paradigm shift in hydrocephalus research in legacy of Dandy\u2019s pioneering work: rationale for third ventriculostomy in communicating hydrocephalus. Childs Nerv Syst 23:487\u2013489, 200710.1007\/s00381-007-0303-z17370078"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"923","DOI":"10.3171\/JNS\/2008\/109\/11\/0923","article-title":"Endoscopic third ventriculostomy in the management of communicating hydrocephalus: a preliminary study","volume":"109","author":"Hailong F","year":"2008","unstructured":"Hailong F, Guangfu H, Haibin T, Hong P, Yong C, Weidong L, : Endoscopic third ventriculostomy in the management of communicating hydrocephalus: a preliminary study. J Neurosurg 109:923\u2013930, 200810.3171\/JNS\/2008\/109\/11\/092318976086"},{"key":"b10","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1097\/00006123-199904000-00062","article-title":"Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures","volume":"44","author":"Hopf NJ","year":"1999","unstructured":"Hopf NJ, Grunert P, Fries G, Resch KDM, Perneczky A: Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurgery 44:795\u2013806, 19991020130510.1097\/00006123-199904000-00062"},{"key":"b11","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1227\/00006123-199305000-00024","article-title":"Third ventriculostomy for shunt infections in children","volume":"32","author":"Jones RFC","year":"1993","unstructured":"Jones RFC, Stening WA, Kwok BCT, Sands TM: Third ventriculostomy for shunt infections in children. Neurosurgery 32:855\u2013860, 199310.1227\/00006123-199305000-000248492866"},{"key":"b12","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1159\/000068053","article-title":"Extraventricular intracisternal obstructive hydrocephalus\u2014a hypothesis to explain successful 3rd ventriculostomy in communicating hydrocephalus","volume":"38","author":"Kehler U","year":"2003","unstructured":"Kehler U, Gliemroth J: Extraventricular intracisternal obstructive hydrocephalus\u2014a hypothesis to explain successful 3rd ventriculostomy in communicating hydrocephalus. Pediatr Neurosurg 38:98\u2013101, 200310.1159\/00006805312566844"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"865","DOI":"10.3171\/jns.1991.75.6.0865","article-title":"Stereotactic third ventriculostomy in patients with nontumoral adolescent\/adult onset aqueductal stenosis and symptomatic hydrocephalus","volume":"75","author":"Kelly PJ","year":"1991","unstructured":"Kelly PJ: Stereotactic third ventriculostomy in patients with nontumoral adolescent\/adult onset aqueductal stenosis and symptomatic hydrocephalus. J Neurosurg 75:865\u2013873, 1991194111510.3171\/jns.1991.75.6.0865"},{"key":"b14","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1007\/s00381-016-3055-9","article-title":"Simultaneous ventriculoperitoneal shunt removal and endoscopic third ventriculostomy for three patients previously treated for intracranial germ cell tumors more than 20 years ago","volume":"32","author":"Kita D","year":"2016","unstructured":"Kita D, Hayashi Y, Fukui I, Oishi M, Nakada M: Simultaneous ventriculoperitoneal shunt removal and endoscopic third ventriculostomy for three patients previously treated for intracranial germ cell tumors more than 20 years ago. Childs Nerv Syst 32:1543\u20131547, 20162699401210.1007\/s00381-016-3055-9"},{"key":"b15","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"310","DOI":"10.3171\/2010.8.PEDS103","article-title":"Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV Success Score","volume":"6","author":"Kulkarni AV","year":"2010","unstructured":"Kulkarni AV, Drake JM, Kestle JRW, Mallucci CL, Sgouros S, Constantini S: Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV Success Score. J Neurosurg Pediatr 6:310\u2013315, 201010.3171\/2010.8.PEDS10320887100"},{"key":"b16","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.jpeds.2009.02.048","article-title":"Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus","volume":"155","author":"Kulkarni AV","year":"2009","unstructured":"Kulkarni AV, Drake JM, Mallucci CL, Sgouros S, Roth J, Constantini S: Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus. J Pediatr 155:254\u2013259, 259.e1, 200910.1016\/j.jpeds.2009.02.048"},{"key":"b17","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"143","DOI":"10.3171\/2010.11.PEDS10296","article-title":"Use of the ETV Success Score to explain the variation in reported endoscopic third ventriculostomy success rates among published case series of childhood hydrocephalus","volume":"7","author":"Kulkarni AV","year":"2011","unstructured":"Kulkarni AV, Riva-Cambrin J, Browd SR: Use of the ETV Success Score to explain the variation in reported endoscopic third ventriculostomy success rates among published case series of childhood hydrocephalus. J Neurosurg Pediatr 7:143\u2013146, 201110.3171\/2010.11.PEDS1029621284458"},{"key":"b18","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1007\/s00381-010-1130-1","article-title":"Endoscopic third ventriculostomy in previously shunted children: a retrospective study","volume":"26","author":"Marton E","year":"2010","unstructured":"Marton E, Feletti A, Basaldella L, Longatti P: Endoscopic third ventriculostomy in previously shunted children: a retrospective study. Childs Nerv Syst 26:937\u2013943, 20102035223310.1007\/s00381-010-1130-1"},{"key":"b19","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"494","DOI":"10.3171\/2011.8.PEDS1145","article-title":"Evaluating the Children\u2019s Hospital of Alabama endoscopic third ventriculostomy experience using the Endoscopic Third Ventriculostomy Success Score: an external validation study","volume":"8","author":"Naftel RP","year":"2011","unstructured":"Naftel RP, Reed GT, Kulkarni AV, Wellons JC: Evaluating the Children\u2019s Hospital of Alabama endoscopic third ventriculostomy experience using the Endoscopic Third Ventriculostomy Success Score: an external validation study. J Neurosurg Pediatr 8:494\u2013501, 201110.3171\/2011.8.PEDS114522044376"},{"key":"b20","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4103\/2152-7806.106116","article-title":"Endoscopic third ventriculostomy for shunt malfunction: what to do with the shunt?","volume":"4","author":"Neils DM","year":"2013","unstructured":"Neils DM, Wang H, Lin J: Endoscopic third ventriculostomy for shunt malfunction: what to do with the shunt? Surg Neurol Int 4:3, 201310.4103\/2152-7806.106116"},{"key":"b21","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.3171\/jns.2003.98.5.1027","article-title":"Changes in cerebrospinal fluid hydrodynamics following endoscopic third ventriculostomy for shunt-dependent noncommunicating hydrocephalus","volume":"98","author":"Nishiyama K","year":"2003","unstructured":"Nishiyama K, Mori H, Tanaka R: Changes in cerebrospinal fluid hydrodynamics following endoscopic third ventriculostomy for shunt-dependent noncommunicating hydrocephalus. J Neurosurg 98:1027\u20131031, 200310.3171\/jns.2003.98.5.102712744362"},{"issue":"5 Suppl","key":"b22","series-title":"J Neurosurg","first-page":"393","article-title":"Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction","volume":"103","author":"O\u2019Brien DF","year":"2005","unstructured":"O\u2019Brien DF, Javadpour M, Collins DR, Spennato P, Mallucci CL: Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction. J Neurosurg 103 (5 Suppl):393\u2013400, 200516302610"},{"key":"b23","series-title":"Minimally Invasive Techniques for Neurosurgery","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/978-3-642-58731-3_13","article-title":"Ultrasound-guided endoscopic fenestration of the third ventricle in obstructive hydrocephalus","author":"Rieger A","year":"1998","unstructured":"Rieger A, Rainov NG, Sanchin L, Sch\u00f6pp G, Burkert W: Ultrasound-guided endoscopic fenestration of the third ventricle in obstructive hydrocephalus, in Hellwig D, Bauer BL (eds): Minimally Invasive Techniques for Neurosurgery. Berlin: Springer, 1998, pp 81\u20138510.1007\/978-3-642-58731-3_13"},{"key":"b24","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"320","DOI":"10.3171\/2011.12.PEDS11229","article-title":"Role of endoscopic third ventriculostomy at infected cerebrospinal fluid shunt removal","volume":"9","author":"Shimizu T","year":"2012","unstructured":"Shimizu T, Luciano MG, Fukuhara T: Role of endoscopic third ventriculostomy at infected cerebrospinal fluid shunt removal. J Neurosurg Pediatr 9:320\u2013326, 201210.3171\/2011.12.PEDS1122922380962"},{"issue":"2 Suppl","key":"b25","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"22.e21","DOI":"10.1016\/j.wneu.2012.02.005","article-title":"Third ventriculostomy in shunt malfunction","volume":"79","author":"Spennato P","year":"2013","unstructured":"Spennato P, Ruggiero C, Aliberti F, Nastro A, Mirone G, Cinalli G: Third ventriculostomy in shunt malfunction. World Neurosurg 79 (2 Suppl):22.e21\u201322.e26, 201310.1016\/j.wneu.2012.02.005"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/131\/4\/article-p1004.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/131\/4\/article-p1004.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/131\/4\/article-p1004.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T03:58:39Z","timestamp":1742702319000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/131\/4\/article-p1004.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":25,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2018.6.jns1865","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}