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.

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.

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

Short and Long Term Outcome In Patients with Calcified Lesions Requiring Rotational Artherectomy

2021 ◽  
Vol 35 (2) ◽  
pp. 140-146
Author(s):  
Lima Asrin Sayami ◽  
Al Fazir Omar ◽  
Sheikh Ziarat Islam ◽  
Subasni Govindan ◽  
Zulaikha Zainal ◽  
...  
Keyword(s):  
P Value ◽  
Success Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Operator Experience ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Short And Long Term ◽  
Procedural Success

Objective: Despite the evolution of interventional techniques and operator experience, percutaneous revascularization of complex coronary lesions especially calcified lesions remains challenging because of lower procedural success and higher restenosis rates. Limited data are available on the effect of rotational atherectomy (RA) plus stenting in the treatment of complex calcified lesions of coronary artery disease. This study was aimed to investigate the characteristics, short and long term outcomes in patients undergoing RA. Material and Methods: A database search was performed from the year 2008 to 2013 in National Heart institute, Malaysia. A total of 16009 patients who underwent PCIs were enrolled in 2 groups, RA group (258 patients) and non RA group (15751 patients). The Chi square test and Kaplan - Meier analysis were used. Results: Male patients (73.6%) and elderly population (63.2%) were predominant in this study.The RA group had more co-morbidities such as diabetic on insulin (34%) and chronic kidney disease (57%). The lesions in RA group were more complex with higher Type C lesion (68.8%) and longer lesion (20.6%) compared to non RA group. Despite higher patient risk profile, the success rate of revascularization remains high in RA group (99.3%) as in non RA group (97%) (p value 0.89%). More importantly there were no significant difference in in-hospital mortality, myocardial infarction and stent thrombosis in both group (p value 0.1). In 1 year Kaplan - Meier survival graph, there were better survival noted in non RA group (97.7%) compare to RA (89.6%) (p value <0.005), Conclusion: The use of RA allows debulking of a calcified lesion and possibly explains the higher acute procedural success rates. However, the lower 1-yearsurvival in the RA group highlights the higher associated baseline comorbitidity in this group. Therefore, besides coronary intervention, this RA group requires aggressive medical therapy through a multi-disciplinary approach. Bangladesh Heart Journal 2020; 35(2) : 140-146

From Acute to Chronic

2002 ◽  
Vol 92 (7) ◽  
pp. 384-389 ◽  
Author(s):  
Vanessa L. Nubé ◽  
Margaret McGill ◽  
Lynda Molyneaux ◽  
Dennis K. Yue
Keyword(s):  
Disease Activity ◽  
Clinical Decision Making ◽  
Chronic Phase ◽  
Clinical Decision ◽  
Primary Treatment ◽  
Radiographic Assessment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Charcot’S Arthropathy

The monitoring of Charcot’s arthropathy in patients with diabetes mellitus is twofold: 1) assessment of disease activity as the condition progresses from the acute to the chronic phase, and 2) identification of structural abnormalities and complications that may arise as a result of the disease. The former guides the clinician as to the duration of primary treatment, and the latter provides important information regarding the long-term prognosis and facilitates clinical decision making regarding other treatments including surgery, footwear, and orthoses. The mainstay of assessing disease activity remains thorough and regular assessment of swelling, temperature differences, and bony abnormalities. Radiographic assessment performed at baseline and periodically throughout the course of the disease will show stages of early fracture and fragmentation followed by eventual trabecular bridging, ankylosis of the affected joints, and sclerosis, heralding the chronic phase of the disease. Radiographic assessment also provides visualization of bony deformities and prominences. In addition to these assessments, changes may be further quantified by the use of infrared dermal thermography and quantitative bone scanning techniques. Careful clinical monitoring of patients is essential to optimize treatment for acute Charcot’s arthropathy and improve the long-term outcome for patients presenting with this condition. (J Am Podiatr Med Assoc 92(7): 384-389, 2002)

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. 

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