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Retrospektiver und prospektiver Vergleich der klinischen Performance des CertasPlus- mit dem proGAV 2.0-Shuntventil zur Behandlung von Hydrocephalus-Patienten

dc.contributor.advisorRohde, Veit Prof. Dr.
dc.contributor.authorEckert, Nora
dc.titleRetrospektiver und prospektiver Vergleich der klinischen Performance des CertasPlus- mit dem proGAV 2.0-Shuntventil zur Behandlung von Hydrocephalus-Patientende
dc.contributor.refereeRohde, Veit Prof. Dr.
dc.description.abstractengImplantation of a vp-shunt represents the current standard of care in hydrocephalus patients. Both combination valves implanted in this study contain a proprietary differential pressure valve, which is combined with a gravity-regulated anti-siphon device (ASD) in the proGAV valve and with a flow-controlled ASD in the CertasPlus valve. We sought to investigate whether the risk and performance profile differs in the two combination valves. Methods: Assignment of patients to valve type was block randomized in this prospective observational study. The sample consisted of 79 adult patients with hydrocephalus who received a vp-shunt for the first time. The two largest diagnostic subgroups (66 patients in total) were analyzed, namely iNPH (44%, n=35) and secondary communicating hydrocephalus (39%, n=31). Analyzed frontal occipital horn ratio (FOHR) and Evans index were CT derived. FOHR, Evans index and Stein-Langfitt (SL) scores were assessed prior to valve implantation and at follow-up. Black grading scale was assessed at follow-up only. Results: In this intermediate analysis, patients with iNPH compared to patients with secondary communicating hydrocephalus were significantly younger (75 ± 6 years vs. 58 ± 15 years, p<0.01). In patients with secondary communicating hydrocephalus , FOHR and Evans index tended to improve due to valve-treatment (p= 0.10 and p= 0.24) while SL scores improved significantly (p=0.015). No difference between valve types was found, neither on level (p≥ 0.29) nor on time-course (p≥ 0.37). In patients with iNPH, FOHR and Evans score changed significantly due to valve treatment (p≤ 0.01 and show a tendency for improvement of Stein-Langfitt (p= 0.067). Of note, in patients with iNPH, FOHR, Evans, and SL scores prior to valve-implantation had been significantly lower in CP compared to PG (p = 0.0021 multivariate joint test). Postoperative change in Evans (p=0.95) and FOHR did not differ significantly (p=0.39) and no differences were observed in median SL nor Black scale between valves (p=0.64). There were 2 revisions in the PG group (1 wound dehiscence, 1 cranial catheter occlusion) and none in the CP group. No difference in number of valve adjustments between CP and PG (p=0.24) was observed in both hydrocephalus subtypes. Conclusion: VP-shunt insertion for treatment of hydrocephalus can be performed safely and effectively with both valve types. No difference in outcome was noted between both valve typesde
dc.contributor.coRefereeReuss, Bernhard Prof. Dr.
dc.contributor.thirdRefereeSchön, Margarete Prof. Dr.
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullNeurochirurgie (PPN619876271)de
dc.notes.confirmationsentConfirmation sent 2023-09-25T19:45:01de

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