Nonprogrammable and programmable cerebrospinal fluid shunt valves: a 5-year study

Clinical article

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Object

Programmable valves (PVs) for shunting CSF have increasingly replaced nonprogrammable valves (NPVs). There have been only a few longer-term studies (≥ 5 years) conducted that have compared the effectiveness of NPVs with that of PVs for children with hydrocephalus, and only 1 study has reported NPVs as being favorable over PVs. The objective of this retrospective study was to compare the long-term survival of these 2 types of shunt valves.

Methods

The authors collected data for all patients who underwent CSF shunt insertion or revision between January 1, 2000, and December 31, 2008. Patients underwent follow-up for a minimum of 2 years postoperatively. Statistical analyses were done using chi-square, Kaplan-Meier survival curve, and multivariate analyses.

Results

A total of 616 valves were implanted, of which 313 were PVs and 303 were NPVs. Of these, 253 were original shunt implantations and 363 were revisions. The proportion of 5-year survival for NPVs (45.8%) was significantly higher than that for PVs (19.8%) (p = 0.0005, log-rank). The NPVs that survived longer than 6 months also survived through the 5th year better than the PVs (p = 0.0001).

Conclusions

The authors' data suggest that NPVs survive longer than PVs in children, but there is a need for prospective, case-control studies to confirm these data.

Abbreviations used in this paper:HR = hazard ratio; NPV = nonprogrammable valve; PV = programmable valve.

Article Information

Address correspondence to: David B. Shurtleff, M.D., M/S A7938, P.O. Box 5371, Seattle, Washington 98105. email: david.shurtleff@seattlechildrens.org.

Please include this information when citing this paper: DOI: 10.3171/2012.1.PEDS10482.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Kaplan-Meier survival curve for PVs and NPVs including those that were first-insertion cohorts at our institution and underwent follow-up for a minimum of 2 years.

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