Article
First clinical experience using a novel shunt reservoir with a telemetric pressure probe for permanent implantation
Search Medline for
Authors
-
Michael Heckelmann
- Neuochirurgische Abteilung, Krankenhaus Ludmillenstift, Meppen
-
Sebastian Antes
- Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar
-
David Breuskin
- Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar
-
Joachim Oertel
- Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar
-
Christoph Albrecht Tschan
- Neuochirurgische Abteilung, Krankenhaus Ludmillenstift, Meppen
| Published: | June 2, 2015 |
|---|
Outline
Text
Objective: While modern shunt treatment technically evolves, valve settings are still mainly guided by clinical symptoms and imaging. Information about the actual intracranial pressure is desired as parameters for valve adjustment. In this regard an unique device has been developed to allow measurement of intracranial pressure values via the shunt-system. Here we report our experience with the Miethke Sensor Reservoir® (Aesculap/Miethke, Germany) in five patients.
Method: The novel Miethke Sensor Reservoir® was implanted in five selected cases of complex hydrocephalic diseases treated with diversion of cerebrospinal fluid by a ventriculo-peritoneal (n=4) or ventriculo-atrial (n=1) shunt. The implantations were performed between 01/2012 and 11/2013. The patients age ranged from 22 to 55 years, with a median of 33 years. The female to male ratio of the patients was 1:4. A total of 165 measurements were performed in different body positions (lying, sitting, standing) and documented. Follow-up time ranged from 339 to 989 days with a median of 689 days.
Results: All measurements represented plausible and reproducible ICP values. These values were taken into account for the further treatment and valve adjustments. None of the implanted reservoirs was object to revision or failure. The values varied from -1.8 to +23.3 mmHg in the horizontal position with a median of +5.6 mmHg. In sitting position the median value was -4.3 mmHg, ranging from -17.3 to +3.2 mmHg. In standing position led to measurements of -6.4 as median value, ranging from -19.4 to 1.4 mmHg. For clinically good setting the values were: median 4.2 mmHg, range from 0.4 to 10.9 mmHg (supine); median -5.2 mmHg, range from -12.3 to -3.5 mmHg (sitting) and median -6.5 mmHg, ranging from -14.3 to -4.2 mmHg (vertical) respectively.
Conclusions: The use of the novel device, the Sensor Reservoir is safe. The ICP measurements provide helpful parameters to support the adjustment of the shunt valves. Guided by the ICP parameters the settings of the valves could be improved in all cases, leading to a better and stable clinical condition.
