{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:40:05Z","timestamp":1779910805973,"version":"3.53.1"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The insertion of a ventriculoperitoneal shunt (VPS) is a common neurosurgical procedure, but the optimal entry site of the ventricular catheter is still under debate. In this study, the authors compare the parietal (Keen\u2019s) and frontal (Kocher\u2019s) entry sites in terms of the rate of revision surgery due to ventricular catheter misplacement, VPS dysfunction, and VPS infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively analyzed the data on consecutive adults (age \u2265 18 years) who had undergone primary VPS insertion between 2010 and 2020 at two neurosurgical centers. One center regularly inserts the ventricular catheter frontally (frontal group); the other center, parietally (parietal group). The primary outcome of interest was the rate of ventricular catheter misplacement necessitating revision surgery. Secondary outcomes were functional outcome as measured by the modified Rankin Scale (mRS), rate of revision surgery for VPS dysfunction and infection, as well as early (\u2264 30 days) and late (&gt; 30 days) mortality rates. Propensity score matching was performed based on baseline variables, such as normal pressure hydrocephalus, postinfectious hydrocephalus, and idiopathic intracranial hypertension, which were identified as predictors of ventricular catheter misplacement using logistic regression analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Among 539 consecutive patients, 301 (55.8%) were in the frontal group and 238 (44.2%) in the parietal group. Postoperative rates of revision surgery due to misplacement were comparable in the two catheter entry site groups (frontal 14 [4.7%] vs parietal 11 [4.6%], p = 0.987). Rates of revision surgery for VPS dysfunction (14 [4.7%] vs 10 [4.2%], respectively, p = 0.802) and infection (22 [7.3%] vs 10 [4.2%], p = 0.13) exhibited no significant differences. Favorable functional outcomes (mRS score \u2264 2; 164 [76.3%] vs 174 [79.5%], respectively, p = 0.058) and early mortality rates (5 [1.7%] vs 6 [2.5%], p = 0.483) were similar between the groups. After propensity score matching, the primary and secondary outcome measures remained comparable between the groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The entry site of the ventricular catheter in VPS surgery does not seem to affect proximal revision rates. Further, revision rates due to VPS dysfunction, VPS infection, and morbidity were comparable as well.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.2.jns232978","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T03:01:13Z","timestamp":1715396473000},"page":"1418-1426","source":"Crossref","is-referenced-by-count":2,"title":["Effect of cranial entry site on the rate of proximal catheter misplacement in ventriculoperitoneal shunt insertion"],"prefix":"10.3171","volume":"141","author":[{"given":"Florian","family":"Ebel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Amstutz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wanderer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kantonsspital Aarau, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Unterhofer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kantonsspital Aarau, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikan","family":"Toulany","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kantonsspital Aarau, Switzerland;"},{"name":"University Hospital and Faculty of Medicine, University of T\u00fcbingen, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Marbacher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kantonsspital Aarau, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jehuda","family":"Soleman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Basel, Switzerland;"},{"name":"Faculty of Medicine, University of Basel, Switzerland;"},{"name":"Division of Pediatric Neurosurgery, University Children\u2019s Hospital of Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"PLoS One","first-page":"e0198752","article-title":"Yield of early postoperative computed tomography after frontal ventriculoperitoneal shunt placement","volume":"13","author":"Kamenova M","year":"2018","unstructured":"Kamenova M, Rychen J, Guzman R, Mariani L, Soleman J. 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