Conversion of external ventricular drainage to ventriculo-peritoneal shunt: to change or not to change the proximal catheter?

Jehuda Soleman, Haggai Benvenisti, Shlomi Constantini, Jonathan Roth*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: In this study, we investigate the occurrence rate of early shunt infection and malfunction in pediatric patients after converting an external ventricular drainage (EVD) to a ventriculo-peritoneal shunt (VPS) without replacing the ventricular catheter. Methods: Data was retrospectively reviewed for 17 pediatric patients (11 male (64.7%), mean age 7.5 years, range 0.25–15 years) who underwent 18 consecutive direct conversions of tunneled EVD to VPS without replacing the ventricular catheter between 2008 and 2017. In each case, the EVD was inserted in sterile fashion within the operating room and tunneled subcutaneously 5–7 cm away from the insertion site. Primary outcome measure was the occurrence of early (within 30 days) VPS infection or malfunction. The mean follow-up time was 56.8 months (±35.7 months). Results: The mean period of EVD before VPS placement was 9.0 days (±3.6 days, range 2–18 days). Five patients had shunt infections/malfunctions. One patient (5.6%) had an early shunt infection after 30 days. One patient had a late shunt infection after 9 months. One patient had an early shunt malfunction after 9 days. Two patients (11.1%) had late shunt malfunctions after 6.5 months and 9 years. There were no other incidents of shunt-related complications or shunt-related mortality. Conclusion: In the pediatric population, the conversion of a tunneled EVD to a VPS without replacing the ventricular catheter can be safely done. Cranial entry is spared, while the rates of shunt infection and malfunction do not increase significantly.

Original languageEnglish
Pages (from-to)1947-1952
Number of pages6
JournalChild's Nervous System
Volume33
Issue number11
DOIs
StatePublished - 1 Nov 2017
Externally publishedYes

Keywords

  • Hydrocephalus
  • Pediatric neurosurgery
  • Shunt infection
  • Shunt malfunction

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