{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:10:04Z","timestamp":1769598604116,"version":"3.49.0"},"reference-count":43,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>While CSF diversion is highly effective at treating hydrocephalus, shunting is unfortunately associated with a very high revision rate. Studies have demonstrated that proximal catheter obstruction is a major cause of failure. A novel proximal access device was developed, and pilot testing was performed in a sheep model of hydrocephalus.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Hydrocephalus was induced in 8 sheep using a cisternal injection of 4 ml of 25% kaolin, and the sheep were randomized to either a standard ventricular catheter or a novel intraparenchymal stent (IPS). Both groups received identical valves and distal catheters. The novel device included a 3D-printed stainless steel port and a 6 \u00d7 40\u2013mm covered peripheral vascular stent. Animals were euthanized for signs of hydrocephalus or at a time point of 2 months. MRI was performed to determine ventricular size. Time to failure and Evans indices were compared using the Wilcoxon rank-sum test.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>All 4 experimental devices were placed without difficulty into the right lateral ventricle. There was a trend toward longer survival in the experimental group (40 vs 26 days, p = 0.24). Within the IPS group, 3 of the 4 sheep did not experience clinical symptoms of shunt failure and had an average of 37% decrease in Evans index. While 3 of 4 traditional proximal catheters demonstrated debris within the inlet holes, there was no obstructive material found in the IPSs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>An IPS was successfully used to treat hydrocephalus in a sheep model. While statistical significance was not achieved, there were clear benefits to using a stent, including a decreased clog rate and the ability to perform a percutaneous revision. Further testing is needed to ensure efficacy and safety prior to human application.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.5.peds22545","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T08:55:26Z","timestamp":1688201726000},"page":"437-446","source":"Crossref","is-referenced-by-count":2,"title":["Treatment of hydrocephalus in an ovine model with an intraparenchymal stent"],"prefix":"10.3171","volume":"32","author":[{"given":"Gabrielle","family":"Santangelo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, Rochester; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Pieters","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, Rochester; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad I.","family":"Jalal","sequence":"additional","affiliation":[{"name":"University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Redi","family":"Rahmani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, Rochester; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard J.","family":"Silberstein","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, Rochester; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, Rochester; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg","first-page":"1065","article-title":"Global hydrocephalus epidemiology and incidence: systematic review and meta-analysis","volume":"130","author":"Dewan MC","year":"2019","unstructured":"Dewan MC, Rattani A, Mekary R,  Global hydrocephalus epidemiology and incidence: systematic review and meta-analysis. 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