{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T06:52:18Z","timestamp":1698475938187},"reference-count":9,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3]]},"abstract":"OBJECTIVE<\/jats:title>The malfunction rates of and trends in various cerebrospinal fluid (CSF) shunt designs have been widely studied, but one area that has received little attention is the comparison of the peritoneal distal slit valve (DSV) shunt to other conventional valve (CV) type shunts. The literature that does exist comes from older case series that provide only indirect comparisons, and the conclusions are mixed. Here, the authors provide a direct comparison of the overall survival and failure trends of DSV shunts to those of other valve type shunts.<\/jats:p><\/jats:sec>METHODS<\/jats:title>Three hundred seventy-two new CSF shunts were placed in pediatric patients at the authors\u2019 institution between January 2011 and December 2015. Only ventriculoperitoneal (VP) shunts were eligible for study inclusion. Ventriculoatrial, lumboperitoneal, cystoperitoneal, subdural-peritoneal, and spinal shunts were all excluded. Rates and patterns of shunt malfunction were compared, and survival curves were generated. Patterns of failure were categorized as proximal failure, distal failure, simultaneous proximal and distal (proximal+distal) failure, removal for infection, externalization for abdominal pseudocyst, and addition of a ventricular catheter for loculated hydrocephalus.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>A total of 232 VP shunts were included in the final analysis, 115 DSV shunts and 117 CV shunts. There was no difference in the overall failure rate or time to failure between the two groups, and the follow-up period was statistically similar between the groups. The DSV group had a failure rate of 54% and a mean time to failure of 17.8 months. The CV group had a failure rate of 50% (p = 0.50) and a mean time to failure of 18.5 months (p = 0.56). The overall shunt survival curves for these two groups were similar; however, the location of failure was significantly different between the two groups. Shunts with DSVs had proportionately more distal failures than the CV group (34% vs 14%, respectively, p = 0.009). DSV shunts were also found to have proximal+distal catheter occlusions more frequently than CV shunts (23% vs 5%, respectively, p = 0.005). CV shunts were found to have significantly more proximal failures than the DSV shunts (53% vs 27%, p = 0.028). However, the only failure type that carried a statistically significant adjusted hazard ratio in a multivariate analysis was proximal+distal catheter obstruction (CV vs DSV shunt: HR 0.21, 95% CI 0.05\u20130.81).<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>There appears to be a difference in the location of catheter obstruction leading to the malfunction of shunts with DSVs compared to shunts with CVs; however, overall shunt survival is similar between the two. These failure types are also affected by other factors such etiology of hydrocephalus and endoscope use. The implications of these findings are unclear, and this topic warrants further investigation.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.9.peds18579","type":"journal-article","created":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T22:01:34Z","timestamp":1580508094000},"page":"209-216","source":"Crossref","is-referenced-by-count":2,"title":["Survival and failure trends of cerebrospinal fluid shunts with distal slit valves: comparative study and literature review"],"prefix":"10.3171","volume":"25","author":[{"given":"Jeremy S.","family":"Wetzel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex D.","family":"Waldman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavlos","family":"Texakalidis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Buster","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila R.","family":"Eshraghi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Wheelus","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery Associates, Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Reisner","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery Associates, Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua J.","family":"Chern","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery Associates, Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/S1042-3680(18)30556-4","article-title":"Complications in ventricular cerebrospinal fluid shunting","volume":"4","author":"Blount JP","year":"1993","unstructured":"Blount JP, Campbell JA, Haines SJ: Complications in ventricular cerebrospinal fluid shunting. Neurosurg Clin N Am 4:633\u2013656, 1993824178710.1016\/S1042-3680(18)30556-4"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"682","DOI":"10.3171\/jns.1997.87.5.0682","article-title":"Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter","volume":"87","author":"Cozzens JW","year":"1997","unstructured":"Cozzens JW, Chandler JP: Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter. J Neurosurg 87:682\u2013686, 199710.3171\/jns.1997.87.5.0682"},{"key":"b3","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1097\/00006123-199808000-00068","article-title":"Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus","volume":"43","author":"Drake JM","year":"1998","unstructured":"Drake JM, Kestle JR, Milner R, Cinalli G, Boop F, Piatt J Jr, : Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery 43:294\u2013305, 1998969608210.1097\/00006123-199808000-00068"},{"key":"b4","series-title":"Pediatr Neurosci","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1159\/000120354","article-title":"\u2018Slit-ventricle syndrome\u2019: etiology and treatment","volume":"14","author":"Epstein F","year":"1988","unstructured":"Epstein F, Lapras C, Wisoff JH: \u2018Slit-ventricle syndrome\u2019: etiology and treatment. Pediatr Neurosci 14:5\u201310, 1988321728410.1159\/000120354"},{"key":"b5","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1227\/00006123-197811000-00004","article-title":"Chronic headache in the shunt-dependent adolescent with nearly normal ventricular volume: diagnosis and treatment","volume":"3","author":"Epstein F","year":"1978","unstructured":"Epstein F, Marlin AE, Wald A: Chronic headache in the shunt-dependent adolescent with nearly normal ventricular volume: diagnosis and treatment. Neurosurgery 3:351\u2013355, 197810.1227\/00006123-197811000-00004310973"},{"key":"b6","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/BF00302772","article-title":"Use of the distal double-slit valve system in children with hydrocephalus","volume":"10","author":"Hahn YS","year":"1994","unstructured":"Hahn YS: Use of the distal double-slit valve system in children with hydrocephalus. Childs Nerv Syst 10:99\u2013103, 199410.1007\/BF003027728033170"},{"issue":"9","key":"b7","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1159\/000120557","article-title":"Mechanical complications in shunts","volume":"17","author":"Sainte-Rose C","year":"1991\u20131992","unstructured":"Sainte-Rose C, Piatt JH, Renier D, Pierre-Kahn A, Hirsch JF, Hoffman HJ, : Mechanical complications in shunts. Pediatr Neurosurg 17:2\u20139, 1991\u2013199210.1159\/000120557"},{"key":"b8","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s00381-001-0544-1","article-title":"Distal slit valve and clinically relevant CSF overdrainage in children with hydrocephalus","volume":"18","author":"Virella AA","year":"2002","unstructured":"Virella AA, Galarza M, Masterman-Smith M, Lemus R, Lazareff JA: Distal slit valve and clinically relevant CSF overdrainage in children with hydrocephalus. Childs Nerv Syst 18:15\u201318, 20021193523810.1007\/s00381-001-0544-1"},{"key":"b9","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3171\/2016.8.PEDS16229","article-title":"Ventricular catheter entry site and not catheter tip location predicts shunt survival: a secondary analysis of 3 large pediatric hydrocephalus studies","volume":"19","author":"Whitehead WE","year":"2017","unstructured":"Whitehead WE, Riva-Cambrin J, Kulkarni AV, Wellons JC III, Rozzelle CJ, Tamber MS, : Ventricular catheter entry site and not catheter tip location predicts shunt survival: a secondary analysis of 3 large pediatric hydrocephalus studies. J Neurosurg Pediatr 19:157\u2013167, 201710.3171\/2016.8.PEDS16229"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/25\/3\/article-p209.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/25\/3\/article-p209.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/25\/3\/article-p209.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T20:01:24Z","timestamp":1681588884000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/25\/3\/article-p209.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":9,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2019.9.peds18579","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3]]}}}