Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Paper

Long-Term Follow-Up Data from the Shunt Design Trial

Kestle J.a · Drake J.b · Milner R.h · Sainte-Rose C.c · Cinalli G.c · Boop F.d · Piatt J.e · Haines S.f · Schiff S.g · Cochrane D.h · Steinbok P.h · MacNeil N.h

Author affiliations

aDivision of Pediatric Neurosurgery, Primary Children’s Medical Center, University of Utah, Salt Lake City, Utah, USA; bDivision of Neurosurgery, Hospital for Sick Children, Toronto, Canada; cService de Neurochirurgie, Hôpital Necker Enfants Malades, Paris, France; dDivision of Neurosurgery, Arkansas Children’s Hospital, Little Rock, Ark.; eDivision of Neurosurgery, Oregon Health Sciences University, Portland, Oreg.; fDivision of Neurosurgery, University of Minnesota, Minneapolis, Minn.; gDivision of Neurosurgery, Children’s National Medical Center, Washington, D.C., USA; hDivision of Neurosurgery, B.C.’s Children’s Hospital, Vancouver, Canada

Related Articles for ""

Pediatr Neurosurg 2000;33:230–236

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: January 10, 2001
Issue release date: November 2000

Number of Print Pages: 7
Number of Figures: 6
Number of Tables: 3

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE

Abstract

Background: A previously reported multicenter randomized trial assessed whether 2 new shunt valve designs would reduce shunt failure rates compared to differential pressure valves. The study did not show a significant difference in the time to first shunt failure. Patients entered the trial between October 1, 1993, and October 31, 1995. The primary results were based on the patients’ status as of October 31, 1996 (a minimum follow-up of 1 year). This report describes the late complications based on the patients’ most recent follow-up. Methods: Three hundred and forty-four hydrocephalic children at 12 North American and European centers were randomized to 1 of 3 valves: a standard differential pressure valve; a Delta valve (PS Medical-Medtronic) or a Sigma valve (NMT Cordis). Patients were followed until their first shunt failure. Shunt failure was defined as shunt surgery for obstruction, overdrainage, loculation or infection. If the shunt did not fail, follow-up was continued until August 31, 1999. Results: One hundred and seventy-seven patients had shunt failure. Shunt obstruction occurred in 131, overdrainage in 13, loculated ventricles in 2 and infection in 29. The overall shunt survival was 62% at 1 year, 52% at 2 years, 46% at 3 years, 41% at 4 years. The survival curves for the 3 valves were similar to those from the original trial and did not show a survival advantage for any particular valve. Conclusions: Prolonged follow-up to date does not alter the primary conclusions of the trial: there does not appear to be one valve that is clearly the best for the initial treatment of pediatric hydrocephalus.

© 2001 S. Karger AG, Basel


References

  1. Drake JM, et al: Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery 1998;43:294–303; discussion 303–305.
  2. Drake J, Kestle J, PHTE Group: Rationale and methodology of the multicenter pediatric cerebrospinal fluid shunt design trial. Childs Nerv Syst 1996;12:434–447.
  3. Kestle J, Drake JM: The pediatric shunt design trial: Lack of evidence for observer bias. Neurosurgery 1997;41:736.
  4. Piatt, JHJ: Cerebrospinal fluid shunt failure: Late is different from early. J Neurosurg 1995;82:363A.
  5. Schiff S, Oakes J: Delayed cerebrospinal-fluid shunt infection in children. Pediatr Neurosci 1989;15:131–135.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: January 10, 2001
Issue release date: November 2000

Number of Print Pages: 7
Number of Figures: 6
Number of Tables: 3

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.