Long-Term Outcome of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

2007 ◽  
Vol 50 (5) ◽  
pp. 265-269 ◽  
Author(s):  
M. Gangemi ◽  
C. Mascari ◽  
F. Maiuri ◽  
U. Godano ◽  
P. Donati ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Third Ventriculostomy ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Endoscopic third ventriculostomy in adult patients

2005 ◽  
Vol 19 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Amin Amini ◽  
Richard H. Schmidt
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Surgical Techniques ◽  
Adult Patients ◽  
Doppler Imaging ◽  
Third Ventriculostomy ◽  
Term Outcome ◽  
Long Term Outcome

Endoscopic third ventriculostomy (ETV) has gained popularity and has become the treatment of choice for certain pediatric and adult hydrocephalic conditions. The authors report their experience with 36 adult patients and evaluate the long-term outcome and safety of ETV. They discuss several improvements to the surgical techniques that they have developed based on their experience, including the use of intraoperative Doppler imaging before fenestration to trace the location of vessels underlying the floor of the third ventricle. They also report the use of a Rickham reservoir and endoventricular stent in selected cases and discuss the indications for their use. In cases of obstructive hydrocephalus due to congenital or acquired aqueductal stenosis in adults, the success rate of ETV in avoidance of shunt placement is 72%. Twenty-two percent of the patients in this series in whom ETV was initially successful later experienced closure of the fenestration and recurrent symptoms at a mean interval of 3.75 years. Thus, in patients who undergo this treatment, long-term periodic follow-up review should be performed.

Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus: validation of a success score that predicts long-term outcome

2011 ◽  
Vol 8 (5) ◽  
pp. 489-493 ◽  
Author(s):  
Andrew J. Durnford ◽  
Fenella J. Kirkham ◽  
Nijaguna Mathad ◽  
Owen C. E. Sparrow
Keyword(s):  
Clinical Decision Making ◽  
Endoscopic Third Ventriculostomy ◽  
Risk Groups ◽  
Individual Characteristics ◽  
Third Ventriculostomy ◽  
Success Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
High Chance

Object The goal of this study was to externally validate the proposed Endoscopic Third Ventriculostomy Success Score (ETVSS), which predicts successful treatment for hydrocephalus on the basis of a child's individual characteristics. Methods The authors retrospectively identified 181 cases of consecutive endoscopic third ventriculostomy (ETV) performed in children at a single neurosurgery center in the United Kingdom. They compared actual success at both 6 and 36 months, with mean predicted probabilities for low, moderate, and high chance of success strata based on the ETVSS. Long-term success was calculated using Kaplan-Meier methods and comparisons were made by means of unpaired t-tests. Results Overall, 166 primary ETVs were performed; ETV success was 72.9% at 6 and 64.5% at 36 months. At long-term follow-up, the mean predicted probability of success was significantly higher in those with a successful ETV (99 patients) than in those with a failed ETV (67 patients) (p = 0.001). The ETVSS accurately predicted outcome at 36 months; the low, medium, and high chance of success strata had mean predicted probabilities of success of 82%, 63%, and 36%, and actual success of 76%, 66%, and 42%, respectively. The overall complication rate was 6%. Conclusions The ETVSS closely predicted the overall long-term success rates in high-, moderate-, and low-risk groups. The results of this study suggest that the ETVSS will aid clinical decision making in predicting outcome of ETV.

scholarly journals Hydrocephalus treatment in children: long-term outcome in 975 consecutive patients

2017 ◽  
Vol 20 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Pierre-Aurelien Beuriat ◽  
Stephanie Puget ◽  
Giuseppe Cinalli ◽  
Thomas Blauwblomme ◽  
Kevin Beccaria ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Differential Pressure ◽  
Third Ventriculostomy ◽  
Term Outcome ◽  
Shunt Insertion ◽  
Long Term Outcome ◽  
Common Cause ◽  
Ventriculoperitoneal Shunting ◽  
Shunt Survival

OBJECTIVEHydrocephalus remains one of the more common pathologies managed in pediatric neurosurgical units. Endoscopic third ventriculostomy (ETV) has an advantage over ventriculoperitoneal shunting as it enables patients to remain device free. Multiple shunt devices with various valve designs exist, with no one valve proven to be superior to another. The aim of this study was to describe the management of hydrocephalus and its long-term outcome.METHODSThe authors retrospectively reviewed the medical records of all patients who had been treated for hydrocephalus at the Hôpital Necker-Enfants Malades in the period from 1985 to 1995.RESULTSNine hundred seventy-five children had been treated for hydrocephalus. The mean follow-up was 11 ± 7.4 years (mean ± standard deviation). The most common cause of hydrocephalus was tumor related (32.3%), followed by malformative (24.5%) and inflammatory (20.9%) causes. Two hundred eighty patients underwent ETV as the first-line treatment. The procedure was effective in controlling hydrocephalus due to posterior fossa tumors and aqueductal stenosis. Six hundred ninety-five children had initial shunt insertion, with the majority receiving an Orbis-Sigma valve (OSV). The overall OSV shunt survival was 70% at 1 year, 58% at 10 years, and 49% at 20 years. The most common cause for mechanical shunt failure was obstruction (50.7%). Overall shunt survival was statistically different between the OSV and the differential-pressure valve (p = 0.009).CONCLUSIONSEndoscopic third ventriculostomy is effective in the management of childhood hydrocephalus. Its success is directly related to the underlying pathology. In the long term, the OSV has significantly higher event-free shunt survival than the classic differential-pressure valve systems

Endoscopic third ventriculostomy for myelomeningocele-related hydrocephalus after shunt failure: Long-term outcome in a series of 8 patients

2021 ◽  
Vol 201 ◽  
pp. 106406
Author(s):  
Nobuyuki Takeshige ◽  
Hisaaki Uchikado ◽  
Daisuke Nakashima ◽  
Tetsuya Negoto ◽  
Satoshi Nagase ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
Shunt Failure ◽  
Term Outcome ◽  
Long Term Outcome

Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review

2003 ◽  
Vol 98 (5) ◽  
pp. 1032-1039 ◽  
Author(s):  
Jürgen Boschert ◽  
Dieter Hellwig ◽  
Joachim K. Krauss
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
The Other ◽  
Third Ventriculostomy ◽  
Content Type ◽  
Shunt Placement ◽  
Occlusive Hydrocephalus ◽  
Shunt Dysfunction ◽  
Fine Print

Object. Endoscopic third ventriculostomy (ETV) is the treatment of choice for occlusive (noncommunicating) hydrocephalus. Nevertheless, its routine use in patients who have previously undergone shunt placement is still not generally accepted. The authors' aim was to investigate the long-term effects of ETV in a group of prospectively chosen patients. Methods. Patients who underwent ETV and had previously undergone shunt placement for occlusive hydrocephalus were followed prospectively for at least 3 years (range 36–103 months, mean 63.6 months). Nine female and eight male patients ranging from 8 to 54 years of age (mean 32 years) had undergone shunt placement 0.7 to 23.5 years (mean 8.1 years) before ETV. Fifteen patients were admitted with underdrainage and two with overdrainage. In six cases, ETV was performed as an emergency operation. The origin of hydrocephalus was aqueductal stenosis in 12 cases and aqueductal compression by a tumor in two cases. Three patients suffered from a fourth ventricle outlet syndrome, and in two patients an additional malresorptive component was suspected. Thirteen patients underwent ETV with shunt removal and insertion of an external drain in one session. The drain served as a safety measure; it could be opened if raised intracranial pressure or ventricular dilation was observed on postoperative imaging studies. In the other four patients the shunt was initially ligated and then removed during a second operation. Fourteen patients (82%) have remained shunt free. The other three patients, including the two with an additional malresorptive component, needed shunt reimplantation 3 days, 2 weeks, or 7 months after ETV. Conclusions. Use of ETV is safe and effective for the treatment for shunt dysfunction in patients with obstructive hydrocephalus.

Long-term outcome in children with low grade tectal tumours and obstructive hydrocephalus

2014 ◽  
Vol 18 (4) ◽  
pp. 469-474 ◽  
Author(s):  
Femke K. Aarsen ◽  
Willem F.M. Arts ◽  
Marie L.C. Van Veelen-Vincent ◽  
Maarten H. Lequin ◽  
Coriene E. Catsman-Berrevoets
Keyword(s):  
Obstructive Hydrocephalus ◽  
Low Grade ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Endoscopic third ventriculostomy for hydrocephalus: a study of thirty cases

2019 ◽  
Vol 6 (4) ◽  
pp. 1120
Author(s):  
Paresh Sodhiya ◽  
Zafar Ahmed Sheikh ◽  
Mukesh Sharma ◽  
Meen Morey
Keyword(s):  
Success Rate ◽  
Age Groups ◽  
Third Ventriculostomy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Abnormal Accumulation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Surgical Modality

Background: Raised intracranial pressure because of abnormal accumulation of CSF with in the ventricles of brain is a potentially life-threatening condition. Ventriculoperitoneal shunt remains mainstay of treatment even today. However, shunt failure is not uncommon. Hence endoscopic procedures are now gaining popularity. The outcome of ETV with respect to age ,etiology and long-term outcome needs further elucidation.Methods: Thirty patients with hydrocephalus who underwent endoscopic treatment were analysed retrospectively with respect to age, diagnosis, surgical outcome, treatment failure and complications.Results: Total of 28 patients successfully underwent ETV and with an overall success rate of 78%. Moreover, the success rate of ETV was found to be 100% in the 0-1 and 80% in 1-2 years age groups. 2 patients required re operation in the form of VP shunt.Conclusions: ETV is a safe and effective surgical modality with comparable outcome in paediatric and adult populations. 

scholarly journals Long-term follow-up of endoscopic third ventriculostomy performed in the pediatric population

2016 ◽  
Vol 17 (6) ◽  
pp. 734-738 ◽  
Author(s):  
Matthew G. Stovell ◽  
Rasheed Zakaria ◽  
Jonathan R. Ellenbogen ◽  
Mathew J. Gallagher ◽  
Michael D. Jenkinson ◽  
...  
Keyword(s):  
Failure Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Third Ventriculostomy ◽  
Shunt Insertion ◽  
Vp Shunt ◽  
Additional Surgery ◽  
Long Term Follow Up

OBJECTIVE Endoscopic third ventriculostomy (ETV) is an effective treatment for obstructive hydrocephalus and avoids the risk for foreign-body infection associated with ventriculoperitoneal (VP) shunts. The short-term failure rate of ETV strongly depends on the indications for its use but is generally thought to be lower in the long term than that of VP shunts. However, few studies are available with long-term follow-up data of ETV for hydrocephalus in children. The authors reviewed the long-term success of ETV at their institution to investigate the rate of any late failures of this procedure. METHODS Between April 1998 and June 2006, 113 children (including neonates and children up to 16 years old) had primary or secondary ETV for different causes of hydrocephalus. The patients' medical records and the authors' electronic operation database were reviewed for evidence of additional surgery (i.e., repeat ETV or VP shunt insertion). These records were checked at both the pediatric and adult neurosurgical hospitals for those patients who had their care transferred to adult services. RESULTS The median length of follow-up was 8.25 years (range 1 month to 16 years). Long-term follow-up data for 96 patients were available, 47 (49%) of whom had additional ETV or VP shunt insertion for ETV failure. Twenty patients (21%) had a second procedure within 1 month, 17 patients (18%) between 1 and 12 months, 7 patients (7%) between 1 and 5 years, and 3 patients (3%) between 5 and 8 years. CONCLUSIONS In the authors' series, ETV had an initial early failure rate for the treatment of pediatric hydrocephalus as reported previously, and this rate significantly depended on patient age and hydrocephalus etiology. Once stabilized and effective, ETV appeared to be durable but not guaranteed, and some late decline in effectiveness was observed, with some ETV failures occurring many years later. Thus, successful ETV in children cannot be guaranteed for life, and some form of follow-up is recommended long term into adulthood.

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