Revision and Complication Rates in First-Time Ventriculoperitoneal Shunt Placement in Adults: A Single-Center, Retrospective Study

Anıl EROL; Nevhis AKINTÜRK; Mustafa Serdar BÖLÜK; Kadri Emre ÇALIŞKAN; Hüseyin BİÇEROĞLU; Erkin ÖZGİRAY; Mehmet Sedat ÇAĞLI; Taşkın YURTSEVEN

Revision and Complication Rates in First-Time Ventriculoperitoneal Shunt Placement in Adults: A Single-Center, Retrospective Study

Bildiriler > Özet Bildiri · 2025

Yazarlar: Anıl EROL, Nevhis AKINTÜRK, Mustafa Serdar BÖLÜK, Kadri Emre ÇALIŞKAN, Hüseyin BİÇEROĞLU, Erkin ÖZGİRAY, Mehmet Sedat ÇAĞLI, Taşkın YURTSEVEN

European Association of Neurosurgical Societies 2025 Annual Congress, Avustralya, Viyana, Uluslararası, Poster, Özet Bildiri, 2025-2025, ss 1-1

Özet

Introduction: Ventriculoperitoneal (VP) shunt placement is the gold-standard treatment for hydrocephalus. Despite being a standard neurosurgical procedure, there is a high revision rate with significant complications. The shunt revisions due to dysfunction or infections increase morbidity and mortality rates. This study evaluates the outcomes of first-time VP shunt insertions in adults. Methods: We conducted a retrospective analysis of adult patients (≥18 years old) who underwent their first VP shunt placement between January 1, 2023, and December 31, 2024, with at least one-month follow-up. Pediatric patients and those with prior shunt revisions were excluded. Demographic data, hydrocephalus etiology, shunt types, insertion sites, postoperative complications, and revision surgeries were collected. Results: A total of 153 patients were included, with a mean age of 58.1 years and 50.3% female. The most common hydrocephalus etiologies were normal pressure hydrocephalus (28.1%), tumor-related hydrocephalus (33.3%), and intracranial hemorrhage (19.6%). The most common symptoms were headache (28.8%), impaired consciousness (15.0%), dementia (38.6%), and ataxia (39.9%). A total of 30 patients (19.6%) had an EVD or LD before shunt placement. Medium-pressure (Delta 1.5) shunts were used in 139 patients (90.8%), with the right occipital burr hole as the preferred insertion site (92.2%). Shunt infection occurred in only one patient (0.65%). 65 revision surgeries were performed in 40 patients (26.1%), with 15 (9.8%) requiring more than two revisions. The mean time to the first revision was 37.9 days. The most common symptoms for the revision were impaired consciousness (49.2%) and headache (12.3%). Revision etiologies included cranial catheter malposition (4.6%), shunt over-drainage (6.2%), abdominal catheter migration and catheter malfunction (10.8% and 3.1%, respectively), infection (16.9%), cranial and pump revision (50.8%). Conclusion: VP shunt placement remains the standard treatment for hydrocephalus; however, our findings emphasize the substantial revision burden, with 1/4 of patients requiring at least one additional surgery and nearly 10% undergoing multiple revisions. The low infection rate (0.65%) suggests effective perioperative management, but catheter and pump-related complications remain the primary cause of revisions. Identifying risk factors for failure and optimizing surgical techniques may improve long-term outcomes.

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