Hall, Benjamin J, S. Gillespie, Conor, Hennigan, Dawn, Bagga, Veejay, Mallucci, Conor 
ORCID: 0000-0002-5509-0547 and Pettorini, Benedetta
(2021)
Efficacy and safety of the Miethke programmable differential pressure valve (proGAV®2.0): a single-centre retrospective analysis.
Child's Nervous System, 37 (8).
pp. 2605-2612.
Abstract
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>Achieving decompression without CSF over-drainage remains a challenge in hydrocephalus. Differential pressure valves are a popular treatment modality, with evidence suggesting that incorporation of gravitational units helps minimise over-drainage. This study seeks to describe the utility of the <jats:italic>proGAV®2.0</jats:italic> programmable valve in a paediatric population.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Clinical records and imaging of all patients fitted with <jats:italic>proGAV®2.0</jats:italic> valves and Miethke fixed-pressure valves between 2014 and 2019 at our tertiary centre were analysed. Patient demographics, indication for shunt and valve insertion/revision and time to shunt/valve revision were collected. Ventricular linear metrics (fronto-occipital horn ratio (FOHR) and fronto-occipital horn width ratio (FOHWR)) were collected pre- and post-valve insertion. Microsoft Excel and SPSS v24 were used for data collection and statistical analysis.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Eighty-eight <jats:italic>proGAV®2.0</jats:italic> valves were inserted in a population of 77 patients (<jats:italic>n</jats:italic> = 45 males (58%), mean age 5.1 years (IQR: 0.4–11.0 years)). A total of 102 Miethke fixed-pressure valves were inserted over the same time period. Median follow-up was 17.5 months (1.0–47.3). One (1.1%) <jats:italic>proGAV®2.0</jats:italic> was revised due to over-drainage, compared to 2 (1.9%) fixed-pressure valves (<jats:italic>p</jats:italic> > 0.05). <jats:italic>ProGAV®2.0</jats:italic> insertion resulted in a significant decrease in the mean number of revisions per patient per year (1.77 vs 0.25; <jats:italic>p</jats:italic> = 0.01). Overall shunt system survival with the <jats:italic>proGAV®2.0</jats:italic> was 80.4% at 12 months, and mean time to revision was 37.1 months, compared to 31.0 months (95%CI: 25.7–36.3) and 58.3% in fixed-pressure valves (<jats:italic>p</jats:italic> < 0.01). Significant decreases were seen following <jats:italic>proGAV®2.0</jats:italic> insertion in both FOHR and FOHWR, by 0.014 (95%CI: 0.006–0.023, <jats:italic>p</jats:italic> = 0.002) and 0.037 (95%CI: 0.005–0.069, <jats:italic>p</jats:italic> = 0.024) respectively.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The <jats:italic>proGAV®2.0</jats:italic> provides effective decompression of hydrocephalic patients, significantly reduces the number of valve revisions per patient and had a significantly greater mean time to revision than fixed-pressure valves.</jats:p> </jats:sec>
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Hydrocephalus, Over-drainage, ProGAV (R) 2.0, Valve |
| Divisions: | Faculty of Health and Life Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 24 May 2021 07:54 |
| Last Modified: | 18 Jan 2023 22:45 |
| DOI: | 10.1007/s00381-021-05162-3 |
| Open Access URL: | https://doi.org/10.1007/s00381-021-05162-3 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3123694 |
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