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Comparative analysis of 333 proGAV® and proGAV 2.0® adjustable valves in pediatric hydrocephalus treatment: survival and complication rate assessment

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Title: Comparative analysis of 333 proGAV® and proGAV 2.0® adjustable valves in pediatric hydrocephalus treatment: survival and complication rate assessment
Authors: Issa, Mohammed, Paggetti, Filippo, Dannehl, Clara, Ueding, Nieke, Krieg, Sandro M., El Damaty, Ahmed
Source: Acta Neurochir (Wien)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Adolescent, Research, Infant, Ventriculoperitoneal Shunt, Cerebrospinal Fluid Shunts, Survival Rate, 03 medical and health sciences, Postoperative Complications, Treatment Outcome, 0302 clinical medicine, Child, Preschool, Humans, Female, Adolescent [MeSH], Female [MeSH], Humans [MeSH], Treatment Outcome [MeSH], Postoperative Complications/epidemiology [MeSH], ProGAV®, Retrospective Studies [MeSH], Ventriculoperitoneal Shunt/adverse effects [MeSH], Survival and complication rates, Survival Rate [MeSH], Adverse events, Hydrocephalus, Infant [MeSH], Male [MeSH], Cerebrospinal Fluid Shunts/methods [MeSH], ProGAV 2.0®, Postoperative Complications/etiology [MeSH], Ventriculoperitoneal Shunt/methods [MeSH], Cerebrospinal Fluid Shunts/adverse effects [MeSH], Child [MeSH], Hydrocephalus/surgery [MeSH], Child, Preschool [MeSH], Child, Retrospective Studies
Description: Objective ProGAV and ProGAV2.0 adjustable valves are extensively used for treating hydrocephalus in pediatric patients. This study aims to conduct a comprehensive comparison between these two valves concerning their survival and complication rates. Methods This retrospective study included all pediatric patients who underwent ProGAV or ProGAV2.0 valve implantation at our neurosurgical clinic from August 2008 to August 2020. A comparative analysis was performed considering age, gender, follow-up duration, complication and survival rates, adjustments, spontaneous adjustments, and adjustment difficulty rates. All valves were followed up for a maximum of 3 years. Results Inclusion involved 333 cases (mean age of 5.4 ± 5.1 years; 54.1% males), comprising 173 cases (52.0%) with ProGAV valve implantation and 160 cases (48.0%) with ProGAV 2.0. Early complications within the first month post-implantation were observed in 51 cases (15.3%). No significant differences were noted in valve implantation indications, age distribution, or survival duration (27.1 vs. 27.8 months, p = 0.629) between the two groups. Predominant indications for implantation were post-hemorrhagic hydrocephalus and aqueduct stenosis for both valve types. Notably, both valves showed non-significantly different explantation rates during the first three years after implantation (34.7% vs. 29.7%, p p = 0.002), and a significantly increased association with difficulties in valve adjustments and spontaneous adjustments ( p = 0.041 and 0.011, respectively). ProGAV2.0 cases displayed notably enhanced clinical and radiological improvement within the initial 6 months after implantation ( p = 0.001 and p = 0.038). Younger children (p = 0.049) and had higher rates of valve explantation ( p ). Conclusion The findings of this study highlight the superior performance of the ProGAV2.0 valve in terms of complication rate and maladjustment rate when employed in the treatment of pediatric hydrocephalus. Both valves demonstrated an acceptable survival rate with 65.3% for ProGAV and 71.3% for ProGAV2.0 within three years of implantation.
Document Type: Article
Other literature type
Language: English
ISSN: 0942-0940
DOI: 10.1007/s00701-024-06348-9
Access URL: https://pubmed.ncbi.nlm.nih.gov/39520603
https://repository.publisso.de/resource/frl:6518491
Rights: CC BY
Accession Number: edsair.doi.dedup.....9cd57816bdd9a625bb98ba02d9036f0e
Database: OpenAIRE
Description
Abstract:Objective ProGAV and ProGAV2.0 adjustable valves are extensively used for treating hydrocephalus in pediatric patients. This study aims to conduct a comprehensive comparison between these two valves concerning their survival and complication rates. Methods This retrospective study included all pediatric patients who underwent ProGAV or ProGAV2.0 valve implantation at our neurosurgical clinic from August 2008 to August 2020. A comparative analysis was performed considering age, gender, follow-up duration, complication and survival rates, adjustments, spontaneous adjustments, and adjustment difficulty rates. All valves were followed up for a maximum of 3 years. Results Inclusion involved 333 cases (mean age of 5.4 ± 5.1 years; 54.1% males), comprising 173 cases (52.0%) with ProGAV valve implantation and 160 cases (48.0%) with ProGAV 2.0. Early complications within the first month post-implantation were observed in 51 cases (15.3%). No significant differences were noted in valve implantation indications, age distribution, or survival duration (27.1 vs. 27.8 months, p = 0.629) between the two groups. Predominant indications for implantation were post-hemorrhagic hydrocephalus and aqueduct stenosis for both valve types. Notably, both valves showed non-significantly different explantation rates during the first three years after implantation (34.7% vs. 29.7%, p p = 0.002), and a significantly increased association with difficulties in valve adjustments and spontaneous adjustments ( p = 0.041 and 0.011, respectively). ProGAV2.0 cases displayed notably enhanced clinical and radiological improvement within the initial 6 months after implantation ( p = 0.001 and p = 0.038). Younger children (p = 0.049) and had higher rates of valve explantation ( p ). Conclusion The findings of this study highlight the superior performance of the ProGAV2.0 valve in terms of complication rate and maladjustment rate when employed in the treatment of pediatric hydrocephalus. Both valves demonstrated an acceptable survival rate with 65.3% for ProGAV and 71.3% for ProGAV2.0 within three years of implantation.
ISSN:09420940
DOI:10.1007/s00701-024-06348-9