{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:20:29Z","timestamp":1791004829284,"version":"4.1.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,7]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The goal of this study was to evaluate the long-term results of a flow-regulating shunt (Orbis Sigma Valve [OSV] II Smart Valve System; Integra NeuroSciences, Sophia Antipolis, France) in the treatment of hydrocephalus, whether it was a first insertion procedure or surgical revision of another type of shunt, in everyday clinical practice in a multicenter prospective study.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Patients of any age who had hydrocephalus underwent implantation of an OSV II system. The primary end point of the study was defined as any shunt-related surgery. The secondary end point was a mechanical complication (shunt obstruction, overdrainage, catheter misplacement, migration, or disconnection) or infection. The overall 5-year shunt survival rates and survival as it applied to different patient subgroups were assessed.<\/jats:p>\n<jats:p content-type=\"fine-print\">Five hundred fifty-seven patients (48% of whom were adults and 52% of whom were children) were selected for OSV II shunt implantation; 196 patients reached the primary end point. Shunt obstruction occurred in 75 patients (13.5%), overdrainage in 10 patients (1.8%), and infection in 46 patients (8.2%). The probability of having experienced a shunt failure\u2014free interval at 1 year was 71% and at 2 years it was 67%; thereafter the probability remained quite stable in following years (62% at the 5-year follow-up examination). No difference in shunt survival was observed between the overall pediatric (\u2264 16 years of age) and adult populations. In the pediatric age group, however, there was a significantly lower rate of shunt survival in children younger than 6 months of age (55% at the 5-year follow-up examination).<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> In this prospective study the authors demonstrate the effectiveness of flow regulation in the treatment of hydrocephalus both in children and in adults. Flow-regulating shunts limit the incidence of overdrainage and shunt-related complications. The overall 5-year shunt survival rate (62%) compares favorably with rates cited in other recently published series.<\/jats:p>","DOI":"10.3171\/jns.2003.99.1.0052","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:53:09Z","timestamp":1242237189000},"page":"52-57","source":"Crossref","is-referenced-by-count":93,"title":["Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used"],"prefix":"10.3171","volume":"99","author":[{"given":"Patrick W.","family":"Hanlo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Cinalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Peter","family":"Vandertop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joop A. J.","family":"Faber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"B\u00f8geskov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svend E.","family":"B\u00f8rgesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Boschert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Chumas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Eder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian K.","family":"Pople","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willy","family":"Serlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eckehard","family":"Vitzthum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Childs Nerv Syst","first-page":"193","article-title":"Overdrainage and shunt technology. 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A scanning electron microscopic perspective.","volume":"61","author":"Gower","year":"1984"},{"key":"b16","series-title":"Z Kinderchir","first-page":"80","article-title":"Should \u201cnormalisation\u201d of the ventricles be the goal of hydrocephalus therapy.","volume":"38","author":"Gruber","year":"1983"},{"key":"b17","series-title":"J Neurosurg Sci","first-page":"123","article-title":"Choroidal and ependymal reactions.","volume":"20","author":"Guiffr\u00e9","year":"1976"},{"key":"b18","series-title":"Acta Neurochir","first-page":"155","article-title":"Surgery of hydrocephalus: past, present and future.","volume":"116","author":"Hirsch","year":"1992"},{"key":"b19","series-title":"Can J Neurol Sci","first-page":"81","article-title":"The use of shunting devices for cerebrospinal fluid in Canada.","volume":"13","author":"Hoffmann","year":"1986"},{"key":"b20","series-title":"Childs Brain","first-page":"137","article-title":"Subtemporal decompression for the slit-ventricle syndrome after shunting in hydrocephalus children.","volume":"5","author":"Holness","year":"1979"},{"key":"b21","series-title":"J Neurosurg","first-page":"536","article-title":"Reexpansion of previously collapsed ventricles: the slit ventricle syndrome.","volume":"56","author":"Hyde-Rowan","year":"1982"},{"key":"b22","series-title":"Childs Nerv Syst","first-page":"524","article-title":"Time-related patterns of ventricular shunt failure.","volume":"10","author":"Kast","year":"1994"},{"key":"b23","series-title":"Pediatr Neurosurg","first-page":"230","article-title":"Long-term follow-up data from the shunt design trial.","volume":"33","author":"Kestle","year":"2000"},{"key":"b24","series-title":"Pediatr Neurosurg","first-page":"283","article-title":"The shunt design trial: variation in surgical experience did not influence shunt survival.","volume":"30","author":"Kestle","year":"1999"},{"key":"b25","series-title":"Neuropediatrics","first-page":"190","article-title":"The slit-ventricle syndrome after shunting in hydrocephalic children.","volume":"13","author":"Kiekens","year":"1982"},{"key":"b26","series-title":"Childs Nerv Syst","first-page":"384","article-title":"Long-term prognosis for children with shunted hydrocephalus.","volume":"10","author":"Kokkonen","year":"1994"},{"key":"b27","series-title":"Clin Infect Dis","first-page":"98","article-title":"Efficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts: meta-analysis.","volume":"17","author":"Langley","year":"1993"},{"key":"b28","series-title":"Pediatr Neurosurg","first-page":"248","article-title":"Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience.","volume":"36","author":"McGirt","year":"2002"},{"key":"b29","series-title":"Pediatric Neurosurgery: Surgery of the Developing Nervous System","first-page":"219","article-title":"Ventricular shunts: complications and results","author":"McLaurin","year":"1989"},{"key":"b30","series-title":"J Neurosurg","first-page":"328","article-title":"Shunt fluid examination: risks and benefits in the evaluation of shunt malfunction and infection.","volume":"61","author":"Noetzel","year":"1984"},{"key":"b31","series-title":"Surg","first-page":"399","article-title":"Treatment of hydrocephalus by direct shunt from ventricle to jugular vein.","volume":"Forum","author":"Nulsen","year":"1952"},{"key":"b32","series-title":"Childs Nerv Syst","first-page":"329","article-title":"The significance of morphological details for developmental outcome in infantile hydrocephalus.","volume":"1","author":"Oberbauer","year":"1985"},{"key":"b33","series-title":"Childs Nerv Syst","first-page":"179","article-title":"Morphological findings of postshunt slit-ventricle in experimental canine hydrocephalus. 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